Retrospective Study of Bone Grafting Procedures Before Implant ...

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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
alt5/ziy-id/ziy-id/ziy00410/ziy3108-10z xppws S1 5/24/10 8:21 Art: ID200361 Input-pja IMPLANT DENTISTRY /VOLUME 19, NUMBER 4 2010 5 donor sites for onlay grafting prior to implant placement. Int J Oral Maxillofac Implants. 1997;12:767-776. 22. Raghoebar GM, Timmenga NM, Reintsema H, et al. Maxillary bone grafting for insertion of endosseous implants: Results after 12–124 months. Clin Oral Impl Res. 2001;12:279-286. 23. Esposito M, Grusovin MG, Coulthard P, et al. The efficacy of various bone augmentation procedures for dental implants: A Cochrane systematic review of randomized controlled clinical trials. Int J Oral Maxillofac Implants. 2006;21:696-710. 24. Freihofer HP, Borstlap WA, Kuijpers- Jagtman AM, et al. Timing and transplant materials for closure of alveolar clefts. A clinical comparison of 296 cases. J Craniomaxillofac Surg. 1993;21:143-148. 25. Booij A, Raghoebar GM, Jansma J, et al. Morbidity of chin bone transplants used for reconstructing alveolar defects in cleft patients. Cleft Palate Craniofac J. 2005;42:533-538. 26. Blay A, Tunchel S, Sendyk WR. Viability of autogenous bone grafts obtained by using bone collectors: Histological and microbiological study. Pesqui Odontol Bras. 2003;17:234-240. 27. Lorenzoni M, Pertl C, Wegscheider W, et al. Retrospective analysis of Frialit-2 implants in the augmented sinus. Int J Periodontics Restorative Dent. 2000;20:255- 267. 28. Ardekian L, Oved-Peleg E, Mactei EE, et al. The clinical significance of sinus membrane perforation during augmentation of the maxillary sinus. J Oral Maxillofac Surg. 2006;64:277-282. 29. Sjöström M, Lundgren S, Sennerby L. A histomorphometric comparison of the bone graft-titanium interface between interpositional and onlay/inlay bone grafting techniques. Int J Oral Maxillofac Implants. 2006;21:52-62. 30. Bell RB, Blakey GH, White RP, et al. Staged reconstruction of the severely atrophic mandible with autogenous bone graft and endosteal implants. J Oral Maxillofac Surg. 2002;60:1135- 1141. Abstract Translations GERMAN / DEUTSCH AUTOR(EN): Gustavo Davi Rabelo, DDS, Priscila Marani de Paula, DDS, Flaviana Soares Rocha, DDS, Cláudia Jordão Silva, DDS, MSc, PhD, Darceny Zanetta-Barbosa, DDS, MSc, PhD Retrospektive Studie von Knochentransplantierungsabläufen vor Einsetzung von Implantaten ZUSAMMENFASSUNG: Zielsetzungen: Diese retrospektive Studie zielte darauf ab, die Sterblichkeit und möglichen Komplikationen bei Augmentation vor Implantateinpflanzung zu beurteilen. Materialien und Methoden: Es wurden die Aufzeichnungen von 93 aufeinander folgenden Patienten mit einer Indikation für die Transplantierung von autologem Knochengewebe vor Implantatsetzung untersucht, die in der Abteilung für Gesichts- und Kieferchirurgie undimplantologie an der staatlichen Universität Uberlândia innerhalb eines Zeitraums von 7 Jahren (Juli 2000 bis Juli 2007) behandelt wurden. Die Notwendigkeit für eine Knochentransplantation wurde durch die fehlenden Möglichkeiten bestimmt, Implantate von ausreichender Länge oder ausreichendem Durchmesser zur Erfüllung der prothetischen Erfordernisse einsetzen zu können, oder aber durch ästhetische Gründe. Ergebnisse: Insgesamt wurden 136 Knochentransplantierungsbehandlungen durchgeführt. Die externe abgeschrägte Linie im Unterkiefer sowie der aufsteigende Ast wurden am häufigsten als Spendebereich (59,64%) eingesetzt und Blocktransplantate (67,64%) waren die am meisten eingesetzten Arten von Transplantaten und dies häufig von der externen schrägen Linie im Unterkiefer / aufsteigendem Ast (52,18%). Thrombozytreiches Plasma wurde in 20,1% aller Fälle verwendet, normalerweise in Verbindung mit partikelförmigem Knochentransplantat. Die meisten chirurgischen Eingriffe wurden im Oberkiefer abgewickelt (75%). Hierbei gab es insgesamt trotzdem weniger Komplikationen zu verzeichnen, als bei Eingriffen im Unterkiefer. Bei den Eingriffen im Oberkiefer war als häufigste Komplikation eine Perforation der Sinusschleimhaut festzustellen, während die Aufdeckung des Transplantats beim Unterkiefer die am häufigsten auftretende Komplikation darstellte. Schlussfolgerungen: Eine alveolare Rekonstruktion unter Verwendung von autogenem Knochengewebe mit anschließender Implantateinpflanzung stellt eine zuverlässige Behandlungsalternative für Patienten mit unzureichendem Knochengewebe dar. Es wurden sehr häufig Komplikationen und Sterblichkeit beobachtet. Allerdings was in nur 6,6% aller Fälle die abschließende Wiederherstellung mit Zahnimplantaten überhaupt nicht möglich. SCHLÜSSELWÖRTER: Knochentransplantat, Implantat, Chirurgie, Komplikationen SPANISH / ESPAÑOL AUTOR(ES): Gustavo Davi Rabelo, DDS, Priscila Marani de Paula, DDS, Flaviana Soares Rocha, DDS, Cláudia Jordão Silva, DDS, MSc, PhD, Darceny Zanetta-Barbosa, DDS, MSc, PhD Estudio retrospectivo de procedimientos de injerto de hueso antes de la colocación del implante ABSTRACTO: Objetivos: El objetivo de este estudio retrospectivo fue evaluar la morbosidad y posibles complicaciones en los procedimientos de aumentación antes de la colocación del implante. Materiales y métodos: Se evaluaron los registros de 93 pacientes consecutivos con indicación de injerto autógeno de hueso antes de la colocación del implante, tratados en el Departamento de Cirugía Oral y Maxilofacial e Implantología de la Universidad Federal Uberlândia, en un período de 7 años (Julio/2000 hasta Julio/2007). La necesidad
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