Horizontal Resorption of Fresh‐Frozen Corticocancellous Bone Blocks in the Reconstruction of the Atrophic Maxilla at 5 Months

Abstract

BackgroundReliable 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.PurposeThis 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 MethodsTwenty-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.ResultsA 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 R2 = 0.44, p = .003) was found between healing time and vital bone percentage.ConclusionsAugmentation 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.

Dental Implant Placement with Simultaneous Anterior Maxillary Reconstruction with Block and Particulate Fresh Frozen Allograft Bone: A Case Report with 24-Month Follow-Up Data

“…The highly satisfactory results we report here are in accordance with the case studies presented by other authors [1, 7, 8]. …”

“…Atrophy of the maxillary bone is caused by trauma, oncologic diseases, oral infections, congenital absence of teeth, or the tridimensional alveolar ridge resorption process subsequent to following dental extractions [1]. …”

Treatment of a bilaterally severely resorbed posterior mandible due to early tooth loss by Guided Bone Regeneration using customized allogeneic bone blocks: A case report with 24 months follow‐up data

“…Altogether, the application of allogeneic bone blocks is recently becoming a popular alternative to conventional augmentation procedures. Although there are some studies and case reports referring to auspicious results in reconstructing maxillary bone defects with allografts, there is still very few literature regarding the successful use of allografts.…”

“…With the rising significance of dental implants, alveolar ridge augmentation is gaining in importance as well. However, in cases of severely resorbed alveolar ridges due to periodontitis, trauma, or extreme resorptions following tooth extractions, bone reconstruction can still be very challenging . The use of autologous bone grafts (ABG) harvested from intra‐ or extraoral areas is seen as gold standard for alveolar ridge reconstruction due to its osteoinductive, osteoconductive, and osteogenic properties .…”

Aplicación de la regeneración ósea guiada con injerto en bloque de mentón en la colocación de implantes

“…La zona donante para el aumento óseo de maxilares pueden ser extraorales, como hueso de calota, cresta iliaca 8 , costilla y tibia, los cuales no son muy recomendados por su morbilidad, riesgos asociados y la necesidad de hospitalización. De las zonas intraorales se puede obtener hueso del cigomático, rama mandibular, tuberosidad de maxilar y sínfisis mandibular, que son los más usados por su menor riesgo asociado, mejor posoperatorio y pudiéndose realizar en el consultorio 7 .…”