Retrospective Study of Bone Grafting Procedures Before Implant ...

alt5/ziy-id/ziy-id/ziy00410/ziy3108-10z xppws S1 5/24/10 8:21 Art: ID200361 Input-pja
4 BONE GRAFTING PROCEDURES BEFORE IMPLANT PLACEMENT •RABELO ET AL
complications, rehabilitation with oral
implants was not possible in only
6.6% of all bone grafting procedures.
Aghaloo and Moy 18 have already indicated
similar success rates between
implants placed into grafted sited
compared with implants placed into
native bone.
Maxillary procedures represented
the majority of surgeries and presented
few complications, which could be related
to the best donor site irrigation.
Sinus mucosa perforations occurred
during sinus floor elevation procedures,
mainly due to technical difficulties.
However, they were not related to
significantly higher loss of implants.
The morbidity and complication rate
of maxillary sinus augmentation reported
in the literature is very low. 28
Raghoebar et al 22 concluded that maxillary
sinus bone grafting with autogenous
bone for the insertion of
implants is a reliable treatment modality
with good long-term results.
The highest incidence of complications
occurred in the mandible.
Temporary sensory disturbances and
graft exposures were the most common
complications. None of them
significantly influenced the success
of rehabilitation.
When grafts are loaded and
stimulated, significant resorption
during the initial 6 months of healing
is relatively common. 9 One-stage
surgery reduces the number of surgical
interventions and the healing
time. However, some authors have
reported better results with the
2-stage than with the 1-stage approach.
8,29 In this study, all cases
were treated by 2-staged surgeries,
allowing revascularization and incorporation
of the graft 22 in a first
moment, followed by osseointegration
of the implant before prosthetic
rehabilitation, which could have
contributed to the high success rates
found. Delayed placement also permits
proper angulation and precise
positioning compared with implants
placed at the time of bone grafting. 30
CONCLUSION
Reconstruction using autogenous
bone followed by implant
placement is a reliable treatment
with high success rates. Complications
and morbidity were noted in
many cases. In 6.61% of all cases,
implant installation was not possible.
This retrospective study of bone
grafting surgeries can serve as a
guide in the prevention of possible
failures and consequently improve
the quality of future procedures.
ACKNOWLEDGMENT
The authors claim to have no
financial interest in any company or
any of the products mentioned in this
article.
REFERENCES
1. Lang NP, Berglundh T, Heitz-
Mayfield LJ, et al. Consensus statements
and recommended clinical procedures regarding
implant survival and complications.
Int J Oral Maxillofac Implants. 2004;
19(suppl):150-154.
2. Chiapasco M, Zaniboni M, Boisco
M. Augmentation procedures for the rehabilitation
of deficient edentulous ridges with
oral implants. Clin Oral Implants Res.
2006;17(Suppl 2):136-159.
3. Simion M, Jovanovic SA, Tinti C, et
al. Long-term evaluation of osseointegrated
implants inserted at the time or after
vertical ridge augmentation. A retrospective
study on 123 implants with 1–5 year
follow-up. Clin Oral Implants Res. 2001;12:
35-45.
4. Friedmann A, Strietzel FP, Maretzki
B, et al. Histological assessment of augmented
jaw bone utilizing a new collagen
barrier membrane compared to a standard
barrier membrane to protect a granular
bone substitute material. Clin Oral Implants
Res. 2002;13:587-594.
5. Araujo MG, Sonohara M, Hayacibara
R, et al. Lateral ridge augmentation
by the use of grafts comprised of autologous
bone or a biomaterial. An experimental
in the dog. J Clin Periodontol. 2002;29:
1122-1131.
6. Barone A, Crespi R, Aldini NN, et
al. Maxillary sinus augmentation: Histologic
and histomorphometric analysis. Int
J Oral Maxillofac Implants. 2005;20:519-
525.
7. Meyer C, Chatelain B, Benarroch M,
et al. Massive sinus-lift procedures with
beta-tricalcium phosphate: Long-term results.
Rev Stomatol Chir Maxillofac. 2009;
110:69-75.
8. Barone A, Covani U. Maxillary alveolar
ridge reconstruction with nonvascularized
autogenous block bone: Clinical
results. J Oral Maxillofac Surg. 2007;65:
2039-2046.
9. Block MS, Kent JN, Kallukaran FU,
et al. Bone maintenance 5 to 10 years after
sinus grafting. J Oral Maxillofac Surg.
1998;56:706-715.
10. Chiapasco M, Colletti G, Romeo E,
et al. Long-term results of mandibular reconstruction
with autogenous bone grafts
and oral implants after tumor resection.
Clin Oral Implants Res. 2008;19:1074-
1080.
11. Meraw SJ, Eckert SE, Yacyshyn
CE, et al. Retrospective review of grafting
techniques utilized in conjunction with
endosseous implant placement. Int
J Oral Maxillofac Implants. 1999;14:744-
747.
12. Kim E, Park E, Choung P. Platelet
concentrates and its effect on bone formation
in calvarial defects: An experimental
study in rabbits. J Prosth Den. 2001;86:
428-433.
13. Kim SG, Kim WK, Park JC, et al. A
comparative study of osseointegration of
Avana implants in a demineralized freezedried
bone alone or with platelet-rich
plasma. J Oral Maxillofac Surg. 2002;60:
1018-1025.
14. Serra e Silva FM, Cortez ALV,
Moreira RWF, et al. Complications of intraoral
donor site for bone grafting prior to
implant placement. Implant Dentistry.
2006;15:420-426.
15. Smolka W, Bosshardt DD,
Mericske-Stern R, et al. Reconstruction of
the severely atrophic mandible using calvarial
split bone grafts for implantsupported
oral rehabilitation. Oral Surg
Oral Med Oral Pathol Oral Radiol Endod.
2006;101:35-42.
16. Lohmann H, Grass G, Rangger C,
et al. Economic impact of cancellous bone
grafting in trauma surgery. Arch Orthop
Trauma Surg. 2007;127:345-348.
17. Lye KW, Deatherage JR, Waite PD.
The use of demineralized bone matrix for
grafting during Le Fort I and chin
osteotomies: Techniques and complications.
J Oral Maxillofac Surg. 2008;66:
1580-1585.
18. Aghaloo TL, Moy PK. Which hard
tissue augmentation techniques are the
most successful in furnishing bony support
for implant placement? Int J Oral
Maxillofac Implants. 2007;22(Suppl):
49-70.
19. Sant’Ana E. Short-term survival of
osseointegrated implants installed in alveolar
ridge reconstructed with autogenous
graft (Thesis submitted to obtain PhD).
Bauru School of Dentistry, São Paulo University,
1997.
20. Schwartz-Arad D, Levin L. Intraoral
autogenous block onlay bone grafting for
extensive reconstruction of atrophic maxillary
alveolar ridges. J Periodontol. 2005;
76:636-641.
21. Misch CM. Comparison of intraoral