Horizontal Resorption of Fresh-Frozen Corticocancellous Bone Blocks in the Reconstruction of the Atrophic Maxilla at 5 Months
Identifieur interne : 005583 ( Ncbi/Checkpoint ); précédent : 005582; suivant : 005584Horizontal Resorption of Fresh-Frozen Corticocancellous Bone Blocks in the Reconstruction of the Atrophic Maxilla at 5 Months
Auteurs : Eugénio Pereira [Portugal] ; Ana Messias [Portugal] ; Ricardo Dias [Portugal] ; Fernando Judas [Portugal] ; Alexander Salvoni [Brésil] ; Fernando Guerra [Portugal]Source :
- Clinical Implant Dentistry and Related Research [ 1523-0899 ] ; 2014.
Abstract
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.
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.
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.
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 (
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.
Url:
DOI: 10.1111/cid.12268
PubMed: 25346211
PubMed Central: 4616242
Affiliations:
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Horizontal Resorption of Fresh-Frozen Corticocancellous Bone Blocks in the Reconstruction of the Atrophic Maxilla at 5 Months</title>
<author><name sortKey="Pereira, Eugenio" sort="Pereira, Eugenio" uniqKey="Pereira E" first="Eugénio" last="Pereira">Eugénio Pereira</name>
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<wicri:noRegion>Coimbra</wicri:noRegion>
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<author><name sortKey="Messias, Ana" sort="Messias, Ana" uniqKey="Messias A" first="Ana" last="Messias">Ana Messias</name>
<affiliation wicri:level="1"><nlm:aff id="au2">†Assistant Lecturer, Faculty of Medicine, University of Coimbra, Coimbra, Portugal;</nlm:aff>
<country xml:lang="fr">Portugal</country>
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<wicri:noRegion>Coimbra</wicri:noRegion>
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<author><name sortKey="Dias, Ricardo" sort="Dias, Ricardo" uniqKey="Dias R" first="Ricardo" last="Dias">Ricardo Dias</name>
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<affiliation wicri:level="1"><nlm:aff id="au5">¶Invited Professor, Faculty of Odontology and Medicine, São Leopoldo Mandic, Campinas, Brazil;</nlm:aff>
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<author><name sortKey="Guerra, Fernando" sort="Guerra, Fernando" uniqKey="Guerra F" first="Fernando" last="Guerra">Fernando Guerra</name>
<affiliation wicri:level="1"><nlm:aff id="au6">**Associate Professor, Faculty of Medicine, University of Coimbra, Coimbra, Portugal</nlm:aff>
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<series><title level="j">Clinical Implant Dentistry and Related Research</title>
<idno type="ISSN">1523-0899</idno>
<idno type="eISSN">1708-8208</idno>
<imprint><date when="2014">2014</date>
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>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.</p>
</sec>
<sec><title>Purpose</title>
<p>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.</p>
</sec>
<sec><title>Materials and Methods</title>
<p>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.</p>
</sec>
<sec><title>Results</title>
<p>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 (<italic>p</italic>
< .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 <italic>R</italic>
<sup>2</sup>
= 0.44, <italic>p</italic>
= .003) was found between healing time and vital bone percentage.</p>
</sec>
<sec><title>Conclusions</title>
<p>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.</p>
</sec>
</div>
</front>
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