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Efficacy of Cancellous Block Allograft Augmentation Prior to Implant Placement in the Posterior Atrophic Mandible
Authors:Joseph Nissan DMD  Oded Ghelfan DMD  Ofer Mardinger DMD  Shlomo Calderon DMD  Gavriel Chaushu DMD  MSc
Affiliation:1. Senior lecturer,;2. instructor, Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel;3. lecturer,;4. professor,;5. senior lecturer, Department of Oral and Maxillofacial Surgery, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
Abstract:Background: The present study evaluated the outcome of ridge augmentation with cancellous freeze‐dried block bone allografts in the posterior atrophic mandible followed by placement of dental implants. Materials and Methods: A bony deficiency of at least 3 mm, horizontally, vertically, or both, according to computerized tomography (CT) para‐axial reconstruction served as inclusion criteria. Implants were inserted after a healing period of 6 months. Bone measurements were taken prior to bone augmentation, during implant placement, and at second‐stage surgery. Marginal bone loss and crown‐to‐implant ratio were also measured. Results: Twenty‐nine cancellous allogeneic bone blocks were placed in 21 patients. The mean follow‐up was 37 months. Bone block survival rate was 79.3%. Mean horizontal and vertical bone gains were 5.6 and 4.3 mm, respectively. Mean buccal bone resorption was 0.5 mm at implant placement and 0.2 mm at second‐stage surgery. A total of 85 implants were placed. Mean bone thickness buccal to the implant neck was 2.5 mm at implant placement and 2.3 mm at second‐stage surgery. There was no evidence of vertical bone loss between implant placement and second‐stage surgery. Implant survival rate was 95.3%. All patients received a fixed implant‐supported prosthesis. At the last follow‐up, the mean marginal bone loss was 0.5 mm. The mean crown‐to‐implant ratio was 0.96. Conclusion: Implant placement in the posterior atrophic mandible following augmentation with cancellous freeze‐dried bone block allografts may be regarded as a viable treatment alternative.
Keywords:augmentation  cancellous block allograft  crown‐to‐implant ratio  implant  posterior mandible
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