title: Long-term Evaluation of Peri-implant Bone Level after Reconstruction of Severely Atrophic Edentulous Maxilla via Vertical and Horizontal Guided Bone Regeneration in Combination with Sinus Augmentation: A Case Series with 1 to 15 Years of Loading.
abstract: BACKGROUND
  To the best of the authors' knowledge, there is very limited clinical data on the outcomes of simultaneous guided bone regeneration (GBR) for horizontal and/or vertical bone gain for the reconstruction of severely atrophic edentulous maxilla. Therefore, the purpose of the clinical series presented herein was to clinically evaluate long-term horizontal and vertical bone gain, as well as implant survival rate after reconstruction of severely atrophic edentulous maxillary ridges.
  
  
  METHODS
  Sixteen patients (mean age: 64.6 ± 14.6 years of age) were consecutively treated for vertical and/or horizontal bone augmentation via GBR in combination with bilateral sinus augmentation utilizing a mixture of autologous and anorganic bovine bone. Implant survival, bone gain, intraoperative/postoperative complications and peri-implant bone loss were calculated up to the last follow-up exam.
  
  
  RESULTS
  Overall, 122 dental implants were placed into augmented sites and have been followed from 12 to 180 months (mean: 76.5 months). Implant survival was 100% (satisfactory survival rate of 97.5%). Mean bone gain was 5.6 mm (max: 9 mm; min: 3 mm) While vertical bone gain was 5.1 ± 1.8 mm; horizontal bone gain was 7.0 ± 1.5 mm. No intraoperative/postoperative complications were noted. Mean peri-implant bone loss values were consistent within the standards for implant success (1.4 ± 1.0 mm). At patient-level, only one patient who had three implants presented with severe peri-implant bone loss.
  
  
  CONCLUSIONS
  Complete reconstruction of an atrophied maxilla can be successfully achieved by means of guided bone regeneration for horizontal and/or vertical bone gain including bilateral sinus augmentation using a mixture of anorganic bovine bone and autologous bone.
authors.affiliation: Assistant Professor, Graduate Implant Dentistry, Loma Linda University, Loma Linda, California; Urban Regeneration Institute, Budapest, Hungary.|Private Practice in Periodontics and Implant Dentistry, Budapest, Hungary.
authors.forename: Istvan A
authors.initials: IA
authors.lastname: Urban
authors.affiliation: Graduate Student, Graduate Periodontics, Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Alberto
authors.initials: A
authors.lastname: Monje
authors.affiliation: Professor, Department of Restorative Dentistry, Director of Graduate Implant Dentistry, Loma Linda University, Loma Linda, CA, USA.
authors.forename: Jaime L
authors.initials: JL
authors.lastname: Lozada
authors.affiliation: Professor and Director of Graduate Periodontics, Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Hom-Lay
authors.initials: HL
authors.lastname: Wang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001284:Atrophy; D001861:Bone Regeneration; D001862:Bone Resorption / Q000473:pathology*; D003131:Combined Modality Therapy; D003758:Dental Implantation, Endosseous / Q000379:methods*; D019232:Dental Restoration Failure; D005260:Female; D005500:Follow-Up Studies; D016557:Guided Tissue Regeneration, Periodontal / Q000379:methods*; D006801:Humans; D057893:Immediate Dental Implant Loading; D008297:Male; D008437:Maxilla / Q000473:pathology* / Q000601:surgery*; D008875:Middle Aged; D009066:Mouth, Edentulous / Q000601:surgery*; D011183:Postoperative Complications / Q000473:pathology*; D059546:Sinus Floor Augmentation / Q000379:methods*
keywords: edentulous maxilla; guided bone regeneration; horizontal ridge augmentation; maxillary reconstruction; sinus augmentation; vertical ridge augmentation