A retrospective evaluation of veneer bone grafts used in ridge augmentation for dental implant therapy

A retrospective evaluation of veneer bone grafts used in ridge augmentation for dental implant therapy
August 2003
By Bob Rishiraj, DDS, BS and MA Cohen
Journal of Oral and Maxillofacial Surgery Зѓў Volume 61 Зѓў Number 8 Зѓў p50 to p50
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Abstract
Purpose: This study retrospectively evaluates treatment outcome of autogenous veneer bone grafts used to augment atrophic alveolar ridges prior to dental implant placement.
Patients and Methods: The records of 356 patients were reviewed and 138 dental implant patients (71 males, 67 females) with an average age of 57.8 years (range 18 to 75 years) were selected. All selected patients required alveolar ridge augmentation as the implant sites were deemed to have inadequate bone for implant placement. The ridge was either too narrow to accept the implant, or required augmentation to place the implant in an ideal position. Ridges were augmented using autogenous bone harvested from the mandibular ramus, mandibular symphysis, or anterior superior iliac crest. Dental implants were then placed in the augmented alveolar ridges.
Results: Of the 138 grafted patients, bone was harvested from the mandibular ramus in 108 cases (78%), mandibular symphysis in 18 cases (13%), and the anterior ilium in 11 cases (8%). In one case, bone was harvested from both the mandibular symphysis and ramus for volume. Three hundred six implants were placed in bone grafted sites. Complications from the bone donor site included: paresthesia in 2 cases (1.4%), one involving the mental nerve and the other, the inferior alveolar nerve. Infection was involved in 3 cases (2.2%): 1 donor site, the symphysis and 2 recipient sites, 1 anterior maxilla, and 1 posterior mandible. Gingival dehiscence occurred in 11 cases (8%), 7 were in the anterior maxilla and 4 were in the posterior mandible. One complete and one partial bone graft loss occurred (1.4%), both in the anterior maxilla. In the above cases, bone was harvested from the mandibular ramus. Three hundred six implants were placed in the bone grafted sites and 8 failed to osseointegrate (2.6%). Five implants failed in the anterior maxilla where bone was harvested from the mandibular ramus and 3 failed in the posterior mandible. In this group, bone was harvested from the ramus in 2 cases and the anterior iliac crest in 1 case. There were no implant failures from the sites of complete bone or partial bone loss, or from the areas of gingival dehiscence.
Conclusions: The use of autogenous veneer bone grafts to augment atrophic maxillary and mandibular ridges in preparation for dental implant treatment is highly successful. Complications are rare, and even in those cases, implant integration is highly successful. This technique significantly enhances our ability to place dental implants in sites previously thought to be unsuitable.