Mandibles Grafted With Fresh-Frozen Bone: An Evaluation of Implant Outcome

Abstract

In the last decade several studies have been performed to evaluate the clinical outcome of implants inserted into grafted mandibles with autologous bone, but none is available on mandibles grafted with fresh-frozen bone. Thus, we planned a retrospective study on a series of implants inserted into homologue fresh-frozen bone to evaluate their clinical outcome. Twenty-one patients were operated on, 28 onlay grafts were inserted into the mandible, and 63 implants placed. Patients had total and partial edentulism in 11 and 10 cases, respectively. The mean follow-up was 20 months. No or reduced crestal bone resorption was considered an indicator of success rate to evaluate the effect of several host-, implant-, and occlusal-related factors. The difference between the implant-abutment junction and the bone crestal level was defined as the implant abutment junction (IAJ) and calculated at the time of operation and during follow-up by means of radiographs. Delta IAJ, the difference between theIAJ at the last check-up and the IAJ recorded just after the operation, were stratified according to variables of interests. Kaplan-Meier algorithm and Cox regression were then performed to detect those variables statistically associated with the delta IAJ. Only 2 of 63 implants were lost (i.e., survival rates = 96.8%) and no differences were detected among the studied variables. On the contrary, Cox regression showed that prosthetic restoration (i.e., removable dentures) was the only factor correlated with a statistically significant lower delta IAJ (i.e., reduced crestal bone loss) and thus a better clinical outcome. Implants inserted into mandibles grafted with fresh-frozen bone allografts have high survival rates and success rate, which are comparable with those obtained with autologous iliac crest bone grafts.

Long-Term Retrospective Evaluation of Dental Implants Placed in Resorbed Jaws Reconstructed With Appositional Fresh-Frozen Bone Allografts

“…However, rather than aging itself, the specific nature of the disease process, such as osteoporosis, and local bone quality and quantity at the implant site, mostly related to aging, may be considered more important for successful dental implant treatment. 28 When the results reported in this study were contrasted with similar retrospective studies, it seemed that the survival rate was not influenced by sex 19,20 ; furthermore a better outcome for female patients was also reported. 16 In our opinion, because of a higher risk of implant failure associated with osteoporosis and aging, these patients might best be served preoperatively by appropriate referral and endocrinological examinations.…”

“…The same research group obtained a survival rate of 96.8% over a mean follow-up of 20 months on a series of 63 implants inserted in mandibles reconstructed with FFB onlay grafts. 20 When the survival rate was interrelated with possible predictors of implant failures, interesting results emerged from the Kaplan-Meier analysis.…”

Five-Year Results of Implants Inserted Into Freeze-Dried Block Allografts

“…Other studies, using new sterilization techniques, show that the demineralized bone matrix and morphogenetic proteins are preserved. 49,50 New types of sterilization procedures with axial compression forces maintain the allografts biochemical resistance.…”

Fresh-frozen human bone graft to repair defect after mandibular giant follicular cyst removal: a case report

“…Several authors are recently reporting about the use of FFB in oral and maxillofacial surgery (D'Aloja et al 2008;Carinci et al 2009). FFB showed satisfactory biological properties such as its osteoconductive and osteoinductive properties, as well as its biomechanical behavior.…”

“…Recently many authors are applying the use of fresh-frozen human bone grafts in oral and maxillofacial surgery for filling bone defects as a consequence of cysts removal (de Macedo et al 2009) and for reconstructive procedures (Grecchi et al 2009;Contar et al 2009;Carinci et al 2009). …”