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Immediate dental implant placement in calvarial bone grafts to rehabilitate the severely resorbed edentulous maxilla: A prospective pilot study
Authors:Thomas F Putters  Gerry M Raghoebar  Jenneke Klein-Nulend  Arjan Vissink  Jurjen Schortinghuis
Institution:1. Department of Oral and Maxillofacial Surgery (Head Dr. Jurjen Schortinghuis), Treant Hospital, Emmen-Stadskanaal, The Netherlands;2. Department of Oral and Maxillofacial Surgery (Head Prof. Dr. Fred KL Spijkervet), University of Groningen, University Medical Center Groningen (UMCG), Groningen, The Netherlands;3. Department of Oral Cell Biology, Academic Centre for Dentistry Amsterdam (ACTA) (Head Prof. Dr. Cees Kleverlaan), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
Abstract:

Purpose

The aim of this study was to describe the surgical technique of immediate dental implant placement in calvarial grafts for augmentation of the severely resorbed maxilla and to assess the treatment results.

Methods

In 13 patients the maxilla was augmented with calvarial bone followed by simultaneous dental implant placement (total: 68 implants). In the frontal “knife edge” region, implants were inserted in the buccal plated area. In the maxillary sinus area, implants were inserted into alveolar bone that was plated buccally or palatally through the sinus window. After 4 months, the implants were retrieved and subsequently loaded. Per-operative and post-operative variables were scored. One bone biopsy sample was taken for histological analysis.

Results

The surgical procedure and wound healing was uneventful. During abutment connection after 4 months, all implants were fully osseointegrated with no signs of graft resorption. Radiographically, the mean (±SD) peri-implant bone loss after 1 year of functional loading was 0.23 ± 0.44 mm. No implants were lost. Histological examination revealed vital calvarial and maxillary bone with active remodeling.

Conclusion

Immediate dental implant placement in calvarial bone grafts to rehabilitate severely resorbed maxilla is technically feasible and seems to have a high success rate.
Keywords:Maxilla augmentation  Calvarial bone graft  Dental implant  Immediate implant placement  Resorbed maxilla  Osseointegration
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