Immediate loading of dental implants placed in severely resorbed edentulous maxillae reconstructed with Le Fort I osteotomy and interpositional bone grafting

J Periodontol. 2012 Aug;83(8):963-72. doi: 10.1902/jop.2012.110460. Epub 2012 Jan 20.

Abstract

Background: Reconstruction and rehabilitation of atrophic maxillae with bone grafts is a lengthy and demanding procedure. This study reports the immediate loading of 50 implants placed on six extremely atrophied edentulous maxillae reconstructed with Le Fort I osteotomy and iliac bone grafting.

Methods: Six patients, aged 49 to 68 years, with severely atrophied maxillae were treated with Le Fort I osteotomy and iliac bone grafting to allow for implant-borne prosthetic rehabilitation. Four to 5 months thereafter, 50 implants (seven to 10 per patient) were placed in reconstructed maxillae and immediately functionally loaded with a screw-retained definitive prosthesis. The patients were followed by clinical and radiographic examinations for 24 months after prosthetic loading.

Results: The grafting procedure and healing period before implant placement were uneventful in all patients. Two implants were lost within 2 months after prosthesis insertion in two patients, with an overall survival rate of 96%. The prostheses success rate was 100%. At the end of the follow-up period, all remaining implants appeared clinically healthy; crestal bone loss was >1.7 mm for six implants, resulting in a cumulative success rate of 84%.

Conclusion: Immediate loading of implants placed after Le Fort I osteotomy and interpositional iliac bone grafting could be considered a viable protocol to rehabilitate extremely atrophied edentulous maxillae, considerably reducing the treatment time.

MeSH terms

  • Aged
  • Alveolar Process / diagnostic imaging
  • Alveolar Ridge Augmentation / methods*
  • Atrophy
  • Bone Transplantation / methods*
  • Dental Implant-Abutment Design
  • Dental Implants
  • Dental Occlusion, Centric
  • Dental Plaque Index
  • Dental Prosthesis Design
  • Dental Prosthesis Retention
  • Dental Prosthesis, Implant-Supported
  • Dental Restoration Failure
  • Female
  • Follow-Up Studies
  • Humans
  • Immediate Dental Implant Loading / methods*
  • Jaw, Edentulous / rehabilitation
  • Jaw, Edentulous / surgery*
  • Male
  • Maxilla / diagnostic imaging
  • Maxilla / pathology
  • Maxilla / surgery*
  • Middle Aged
  • Osseointegration / physiology
  • Osteotomy, Le Fort / methods*
  • Peri-Implantitis / etiology
  • Periodontal Index
  • Plastic Surgery Procedures / methods
  • Radiography
  • Transplantation, Autologous
  • Treatment Outcome

Substances

  • Dental Implants