Remodeling of calvarial graft in increased atrophic maxillary thickness. A prospective clinical study

Abstract

Purpose This study evaluated the autogenous graft resorption rate in a calvarial block graft in the anterior region of an atrophic maxilla and compared it with the thickness of the remaining ridge. Materials and Methods Twelve patients were included in the study. They were submitted to cranial calotte graft surgery, and there were 40 blocks in total. The thicknesses of the ridges in the crest, middle and apical regions of the blocks were evaluated by computed tomography scan at the times: preoperative (T0), 48 hours (T1) and 6 months (T2) after the reconstructions. Results The resorption of the blocks from T1 to T2 was 13.4%. The greatest remodeling occurred in the alveolar bone crest (20.07%), followed by the middle portion (12.28%), and the apical region (9.5%), but the three regions did not significantly differ between times T1 and T2 (crest P = .07, middle P = .124, apical P = .131). Recipient site with the lowest thickness had the greatest resorption rates (up to 2 mm = 17.6%; from 2 to 4 mm = 17.52%) while than those with a thickness greater than 4 mm had a mean resorption of 8.81%. Conclusions The resorption of the grafts in this study was 13.4%. Higher resorption rates were observed in the alveolar crest areas, where the ridges were less thick.

Treatment of peri‐implant soft tissue dehiscence around implants placed in calvarial bone graft maxilla and mandible 20 years ago: A case report

“…Calvarial bone is considered to be stable, less resorbable than iliac crest bone grafting, 6 and with a very low morbidity of the donor site. 7 Nevertheless, we have to take in consideration the skeletal remodeling over time, especially a centrifugal and apical resorption in the mandible and a centripetal and apical resorption in the maxilla. 8 Probably for this reason, buccal bone wall resorption in F I G U R E 3 20-year follow-up X-ray the maxilla occurred.…”

Survival Rate of Zygomatic Implants for Fixed Oral Maxillary Rehabilitations: A Systematic Review and Meta-Analysis Comparing Outcomes between Zygomatic and Regular Implants

“…Zygomatic implant positioning is an approach that avoids grafting or maxillary sinus augmentation and consequently produces a shorter and more comfortable post-operative morbidity [18][19][20]. In fact, the restoration of severe maxillary atrophies often requires an extensive grafting approach with autologous bone from a calvaria, iliac crest or mandibular graft with an higher surgical morbidity, cost of rehabilitation time and a reduced predictivity [21][22][23].…”