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Stability of simultaneously placed dental implants with autologous bone grafts harvested from the iliac crest or intraoral jaw bone.

Kang YH, Kim HM, Byun JH, Kim UK, Sung IY, Cho YC, Park BW - BMC Oral Health (2015)

Bottom Line: In total, 36 patients (21 men and 15 women) were selected and a retrospective medical record review was performed.Both autologous bone graft groups (iliac bone and jaw bone) showed favorable clinical results, with similar long-term implant stability and overall implant survival rates.These findings demonstrate that simultaneous dental implantation with the autologous intraoral jaw bone graft method may be reliable for the reconstruction of edentulous atrophic alveolar ridges.

View Article: PubMed Central - PubMed

Affiliation: Department of Oral and Maxillofacial Surgery, Gyeongsang National University School of Medicine, Institute of Health Science, Jinju, 660-702, Republic of Korea.

ABSTRACT

Background: Jaw bone and iliac bone are the most frequently used autologous bone sources for dental implant placement in patients with atrophic alveolar ridges. However, the comparative long-term stability of these two autologous bone grafts have not yet been investigated. The aim of this study was to compare the stability of simultaneously placed dental implants with autologous bone grafts harvested from either the iliac crest or the intraoral jaw bone for severely atrophic alveolar ridges.

Methods: In total, 36 patients (21 men and 15 women) were selected and a retrospective medical record review was performed. We compared the residual increased bone height of the grafted bone, peri-implantitis incidence, radiological density in newly generated bones (HU values), and implant stability using resonance frequency analysis (ISQ values) between the two autologous bone graft groups.

Results: Both autologous bone graft groups (iliac bone and jaw bone) showed favorable clinical results, with similar long-term implant stability and overall implant survival rates. However, the grafted iliac bone exhibited more prompt vertical loss than the jaw bone, in particular, the largest vertical bone reduction was observed within 6 months after the bone graft. In contrast, the jaw bone graft group exhibited a slower vertical bone resorption rate and a lower incidence of peri-implantitis during long-term follow-up than the iliac bone graft group.

Conclusions: These findings demonstrate that simultaneous dental implantation with the autologous intraoral jaw bone graft method may be reliable for the reconstruction of edentulous atrophic alveolar ridges.

No MeSH data available.


Related in: MedlinePlus

Images show the simultaneous dental implantation with autologous iliac bone and intraoral jaw bone grafting procedure. a–c Dental implant fixtures are placed with inlay type iliac bone grafts in the maxillary sinus. a The iliac block bone (arrow) is grafted into the sinus floor and fixed with implant fixtures. b The dead space in the sinus floor is filled with mixed bone of autologous particulate iliac bone and demineralized bone matrix (DBM). c The initial bone healing is completed with homogeneous new bone formation around fixtures 6 months postoperatively. d–f Dental implantation with onlay type bone grafts for coverage of the exposed fixtures using autologous iliac particulate bones. d Partial exposure of implant fixtures is viable after implant placement on the irregular mandibular ridge (arrows). e The exposed fixtures are covered with a mixture of particulate iliac bone and DBM. f The grafted bone heals with new bone formation 5 months after bone graft. g–i Photographs show autologous jaw bone grafts, both of onlay- and inlay-type, for simultaneous implantation. g Autologous chin bone is harvested (arrows indicate chin bone harvested sites) and crushed into particulate, then onlay-type grafted for the exposed fixtures in the mandibular ridge (arrowheads indicate fibrin glue injection on particulate jaw bone graft site). h In the maxillary ridge, the exposed fixtures are covered with a mixed bone of particulate jaw bone and DBM (arrows). i Maxillary sinus windows are opened and sinus membrane elevated (arrow), the mixed bone of jaw bone and DBM is subantral inlay-type grafted after placement of implant fixtures
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Fig1: Images show the simultaneous dental implantation with autologous iliac bone and intraoral jaw bone grafting procedure. a–c Dental implant fixtures are placed with inlay type iliac bone grafts in the maxillary sinus. a The iliac block bone (arrow) is grafted into the sinus floor and fixed with implant fixtures. b The dead space in the sinus floor is filled with mixed bone of autologous particulate iliac bone and demineralized bone matrix (DBM). c The initial bone healing is completed with homogeneous new bone formation around fixtures 6 months postoperatively. d–f Dental implantation with onlay type bone grafts for coverage of the exposed fixtures using autologous iliac particulate bones. d Partial exposure of implant fixtures is viable after implant placement on the irregular mandibular ridge (arrows). e The exposed fixtures are covered with a mixture of particulate iliac bone and DBM. f The grafted bone heals with new bone formation 5 months after bone graft. g–i Photographs show autologous jaw bone grafts, both of onlay- and inlay-type, for simultaneous implantation. g Autologous chin bone is harvested (arrows indicate chin bone harvested sites) and crushed into particulate, then onlay-type grafted for the exposed fixtures in the mandibular ridge (arrowheads indicate fibrin glue injection on particulate jaw bone graft site). h In the maxillary ridge, the exposed fixtures are covered with a mixed bone of particulate jaw bone and DBM (arrows). i Maxillary sinus windows are opened and sinus membrane elevated (arrow), the mixed bone of jaw bone and DBM is subantral inlay-type grafted after placement of implant fixtures

Mentions: The edentulous alveolar ridges were exposed with alveolar crest incisions. In the posterior maxilla, the lateral window was opened, and the sinus mucosa was elevated, as previously described [10, 11]. The submerged types of dental implants (BioHorizon™, BioHorizon Implant System, AL, USA; Osstem™, Osstem Implant Co., Seoul, Korea) were placed according to previously calculated positions and depths using surgical stents. The harvested iliac block bone was contoured for transplantation in the sinus floor (subantral inlay block bone graft) to increase initial stabilization of placed implant fixtures (Fig. 1a). Other harvested autologous bone from the ilium or the intraoral jaw bone was reduced to particulate chips and mixed with a demineralized bone matrix (DBM; Bongener™, CGBio Co., Seongnam, Korea), with a volumetric ratio that was two-thirds autologous bone and one-third DBM (v/v ratio: 2:1) for each group, for onlay- and/or inlay-types of bone graft. A mixture of autologous bone and DBM was grafted onto the ridge to cover the implanted fixtures (onlay graft) and transplanted into the sinus floor to fill the cavity between the sinus floor and the membrane (inlay graft) (Fig. 1). Fibrin glue (Greenplast™, Green cross, Yongin, Korea) was injected onto the grafted bones, and covered with an absorbable membrane (CollaGuide™, Bioland Co., Chengwon, Korea). The surgical sites were closed with 3/0 silk. At 5 to 6 months post-simultaneous implant placement with autologous bone graft, the surgical fields were reopened and the healing abutments were connected onto the placed fixtures (Fig. 1c & f). Patients received fixed prostheses with metal or gold ceramic crowns and bridges.Fig. 1


Stability of simultaneously placed dental implants with autologous bone grafts harvested from the iliac crest or intraoral jaw bone.

Kang YH, Kim HM, Byun JH, Kim UK, Sung IY, Cho YC, Park BW - BMC Oral Health (2015)

Images show the simultaneous dental implantation with autologous iliac bone and intraoral jaw bone grafting procedure. a–c Dental implant fixtures are placed with inlay type iliac bone grafts in the maxillary sinus. a The iliac block bone (arrow) is grafted into the sinus floor and fixed with implant fixtures. b The dead space in the sinus floor is filled with mixed bone of autologous particulate iliac bone and demineralized bone matrix (DBM). c The initial bone healing is completed with homogeneous new bone formation around fixtures 6 months postoperatively. d–f Dental implantation with onlay type bone grafts for coverage of the exposed fixtures using autologous iliac particulate bones. d Partial exposure of implant fixtures is viable after implant placement on the irregular mandibular ridge (arrows). e The exposed fixtures are covered with a mixture of particulate iliac bone and DBM. f The grafted bone heals with new bone formation 5 months after bone graft. g–i Photographs show autologous jaw bone grafts, both of onlay- and inlay-type, for simultaneous implantation. g Autologous chin bone is harvested (arrows indicate chin bone harvested sites) and crushed into particulate, then onlay-type grafted for the exposed fixtures in the mandibular ridge (arrowheads indicate fibrin glue injection on particulate jaw bone graft site). h In the maxillary ridge, the exposed fixtures are covered with a mixed bone of particulate jaw bone and DBM (arrows). i Maxillary sinus windows are opened and sinus membrane elevated (arrow), the mixed bone of jaw bone and DBM is subantral inlay-type grafted after placement of implant fixtures
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4696287&req=5

Fig1: Images show the simultaneous dental implantation with autologous iliac bone and intraoral jaw bone grafting procedure. a–c Dental implant fixtures are placed with inlay type iliac bone grafts in the maxillary sinus. a The iliac block bone (arrow) is grafted into the sinus floor and fixed with implant fixtures. b The dead space in the sinus floor is filled with mixed bone of autologous particulate iliac bone and demineralized bone matrix (DBM). c The initial bone healing is completed with homogeneous new bone formation around fixtures 6 months postoperatively. d–f Dental implantation with onlay type bone grafts for coverage of the exposed fixtures using autologous iliac particulate bones. d Partial exposure of implant fixtures is viable after implant placement on the irregular mandibular ridge (arrows). e The exposed fixtures are covered with a mixture of particulate iliac bone and DBM. f The grafted bone heals with new bone formation 5 months after bone graft. g–i Photographs show autologous jaw bone grafts, both of onlay- and inlay-type, for simultaneous implantation. g Autologous chin bone is harvested (arrows indicate chin bone harvested sites) and crushed into particulate, then onlay-type grafted for the exposed fixtures in the mandibular ridge (arrowheads indicate fibrin glue injection on particulate jaw bone graft site). h In the maxillary ridge, the exposed fixtures are covered with a mixed bone of particulate jaw bone and DBM (arrows). i Maxillary sinus windows are opened and sinus membrane elevated (arrow), the mixed bone of jaw bone and DBM is subantral inlay-type grafted after placement of implant fixtures
Mentions: The edentulous alveolar ridges were exposed with alveolar crest incisions. In the posterior maxilla, the lateral window was opened, and the sinus mucosa was elevated, as previously described [10, 11]. The submerged types of dental implants (BioHorizon™, BioHorizon Implant System, AL, USA; Osstem™, Osstem Implant Co., Seoul, Korea) were placed according to previously calculated positions and depths using surgical stents. The harvested iliac block bone was contoured for transplantation in the sinus floor (subantral inlay block bone graft) to increase initial stabilization of placed implant fixtures (Fig. 1a). Other harvested autologous bone from the ilium or the intraoral jaw bone was reduced to particulate chips and mixed with a demineralized bone matrix (DBM; Bongener™, CGBio Co., Seongnam, Korea), with a volumetric ratio that was two-thirds autologous bone and one-third DBM (v/v ratio: 2:1) for each group, for onlay- and/or inlay-types of bone graft. A mixture of autologous bone and DBM was grafted onto the ridge to cover the implanted fixtures (onlay graft) and transplanted into the sinus floor to fill the cavity between the sinus floor and the membrane (inlay graft) (Fig. 1). Fibrin glue (Greenplast™, Green cross, Yongin, Korea) was injected onto the grafted bones, and covered with an absorbable membrane (CollaGuide™, Bioland Co., Chengwon, Korea). The surgical sites were closed with 3/0 silk. At 5 to 6 months post-simultaneous implant placement with autologous bone graft, the surgical fields were reopened and the healing abutments were connected onto the placed fixtures (Fig. 1c & f). Patients received fixed prostheses with metal or gold ceramic crowns and bridges.Fig. 1

Bottom Line: In total, 36 patients (21 men and 15 women) were selected and a retrospective medical record review was performed.Both autologous bone graft groups (iliac bone and jaw bone) showed favorable clinical results, with similar long-term implant stability and overall implant survival rates.These findings demonstrate that simultaneous dental implantation with the autologous intraoral jaw bone graft method may be reliable for the reconstruction of edentulous atrophic alveolar ridges.

View Article: PubMed Central - PubMed

Affiliation: Department of Oral and Maxillofacial Surgery, Gyeongsang National University School of Medicine, Institute of Health Science, Jinju, 660-702, Republic of Korea.

ABSTRACT

Background: Jaw bone and iliac bone are the most frequently used autologous bone sources for dental implant placement in patients with atrophic alveolar ridges. However, the comparative long-term stability of these two autologous bone grafts have not yet been investigated. The aim of this study was to compare the stability of simultaneously placed dental implants with autologous bone grafts harvested from either the iliac crest or the intraoral jaw bone for severely atrophic alveolar ridges.

Methods: In total, 36 patients (21 men and 15 women) were selected and a retrospective medical record review was performed. We compared the residual increased bone height of the grafted bone, peri-implantitis incidence, radiological density in newly generated bones (HU values), and implant stability using resonance frequency analysis (ISQ values) between the two autologous bone graft groups.

Results: Both autologous bone graft groups (iliac bone and jaw bone) showed favorable clinical results, with similar long-term implant stability and overall implant survival rates. However, the grafted iliac bone exhibited more prompt vertical loss than the jaw bone, in particular, the largest vertical bone reduction was observed within 6 months after the bone graft. In contrast, the jaw bone graft group exhibited a slower vertical bone resorption rate and a lower incidence of peri-implantitis during long-term follow-up than the iliac bone graft group.

Conclusions: These findings demonstrate that simultaneous dental implantation with the autologous intraoral jaw bone graft method may be reliable for the reconstruction of edentulous atrophic alveolar ridges.

No MeSH data available.


Related in: MedlinePlus