Implant treatment without bone grafting in severely resorbed edentulous maxillae

• Published in: Journal of oral and maxillofacial surgery Vol. 57; no. 3; pp. 281 - 287
• Main Authors: Mattsson, Torsten, Köndell, Per-Åke, Gynther, Göran W, Fredholm, Ulf, Bolin, Anders
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.03.1999; Elsevier
• Subjects: Adult; Aged; Alveolar Bone Loss - rehabilitation; Biological and medical sciences; Dental Implantation, Endosseous - methods; Dental Prosthesis, Implant-Supported; Dentistry; Ent and stomatology; Female; Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics; Humans; Jaw, Edentulous - rehabilitation; Jaw, Edentulous - surgery; Male; Maxilla; Maxillary Sinus - surgery; Maxillofacial surgery. Dental surgery. Orthodontics; Medical sciences; Medicin och hälsovetenskap; Middle Aged; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Stomatology; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Treatment Outcome; Human; Edentulousness; Osteointegration; Implant; Stomatology; Prosthesis; Dental disease; Diseases of the osteoarticular system; Maxillary; Resorption; Instrumentation; Result; Fixation; Surgery; Combined treatment; Tooth; Technique; Maxillary disease
• ISSN: 0278-2391; 1531-5053
• DOI: 10.1016/S0278-2391(99)90673-0

Purpose: This article describes the surgical technique for implant treatment in severely resorbed edentulous maxillae without any alveolar reconstruction before or combined with implant placement. Patients and Material: Fifteen patients with severely resorbed edentulous maxillae were treated with osseointegrated implants and fixed dental prostheses. All patients were initially considered to be treated with bone grafting because of a lack of sufficient bone volume for conventional treatment. Preoperative radiographic examinations showed that the height of the alveolar crest was on average 7.4 mm at the 4-mm-width level (Classes V to VI). Results: By fenestration of the maxillary sinus and uncovering the nasal floor, the maxillary bone could be visualized and used maximally for installation of implants. By angulation of the implants and permitting two to five uncovered fixture threads on the palatal aspect, implants of optimal length could be installed. Eighty-six implants were placed (four to six implants in every patient). One implant was lost during the observation time (range, 36 to 54 months; mean, 45 months). All patients had stable fixed prostheses at the end of the observation time. Conclusion: This cost-effective surgical technique may be considered as an alternative to more resource-demanding techniques such as bone grafting in patients with severely resorbed edentulous maxillae. However, further prospective comparative studies are necessary for full evaluation.