Institute for Facial Esthetics

Prosthodontic Insights Newsletter

May 2000 Volume 13, Number 1

Reconstructive Procedures With Endosseous
Implants in Grafted Bone: A
Review of the Literature
DE Tolman

A review of selected journals published between April 1994 and November 1994 and a MEDLINE search (1976 through April 1994) relative to reconstructive procedures of the mandible and maxilla in which endosseous implants were placed in grafted bone, revealed that 591 patients received 733 grafts in which 2,315 implants were placed. The types of grafts reported were block, autogenous bone (nonvascularized or vascularized) and particulate with a variety of materials.

Regarding mandibular grafts, review of this information revealed that a block graft (either nonvascularized or vascularized with either immediate or delayed placement of implants), rather than a particulate graft, should provide excellent results.

Review of this material for maxillary reconstruction indicated that surgeons preferred nonvascularized block grafts for the onlay procedure. Data on the maxillary sinus inlay procedure revealed that surgeons used block and particulate grafts equally and that similar numbers of implants were placed in each type of graft with similar overall implant-survival rates. However, the survival rate for immediate implant placement was higher than the survival rates for delayed implants in either type of graft. Wound dehiscence seemed to have the most negative effect on the implant survival.

It was difficult to formulate conclusions from a review of these articles because detailed data were not available for all of the techniques discussed. Long-term, detailed follow-up studies are necessary for continued advancement of bone graft techniques utilizing implants.

Download PDF for Insights May 2000, Vol. 13, No. 1

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