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Horizontal Resorption of Fresh‐Frozen Corticocancellous Bone Blocks in the Reconstruction of the Atrophic Maxilla at 5 Months
Author(s) -
Pereira Eugénio,
Messias Ana,
Dias Ricardo,
Judas Fernando,
Salvoni Alexander,
Guerra Fernando
Publication year - 2015
Publication title -
clinical implant dentistry and related research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.338
H-Index - 85
eISSN - 1708-8208
pISSN - 1523-0899
DOI - 10.1111/cid.12268
Subject(s) - medicine , alveolar ridge , dentistry , implant , maxilla , prosthesis , bone resorption , iliac crest , resorption , bone grafting , surgery , pathology
Background Reliable implant‐supported rehabilitation of an alveolar ridge needs sufficient volume of bone. In order to achieve a prosthetic‐driven positioning, bone graft techniques may be required. Purpose This prospective cohort study aims to clinically evaluate the amount of resorption of corticocancellous fresh‐frozen allografts bone blocks used in the reconstruction of the severe atrophic maxilla. Materials and Methods Twenty‐two partial and totally edentulous patients underwent bone augmentation procedures with fresh‐frozen allogenous blocks from the iliac crest under local anesthesia. Implants were inserted into the grafted sites after a healing period of 5 months. Final fixed prosthesis was delivered ± 4 months later. Ridge width analysis and measurements were performed with a caliper before and after grafting and at implant insertion. Bone biopsies were performed in 16 patients. Results A total of 98 onlay block allografts were used in 22 patients with an initial mean alveolar ridge width of 3.41 ± 1.36 mm. Early exposure of blocks was observed in four situations and one of these completely resorbed. Mean horizontal bone gain was 3.63 ± 1.28 mm ( p < .01). Mean buccal bone resorption between allograph placement and the reopening stage was 0.49 ± 0.54 mm, meaning approximately 7.1% (95% confidence interval: [5.6%, 8.6%]) of total ridge width loss during the integration period. One hundred thirty dental implants were placed with good primary stability (≥ 30 Ncm). Four implants presented early failure before the prosthetic delivery (96.7% implant survival). All patients were successfully rehabilitated. Histomorphometric analysis revealed 20.9 ± 5.8% of vital bone in close contact to the remaining grafted bone. A positive strong correlation (adjusted R 2 = 0.44, p = .003) was found between healing time and vital bone percentage. Conclusions Augmentation procedures performed using fresh‐frozen allografts from the iliac crest are a suitable alternative in the reconstruction of the atrophic maxilla with low resorption rate at 5 months, allowing proper stability of dental implants followed by fixed prosthetic rehabilitation.