Simultaneous one stage implant placement and bone grafting with zygomatic bone-a prospective study of 32 consecutive patients

Simultaneous one stage implant placement and bone grafting with zygomatic bone-a prospective study of 32 consecutive patients
August 2003
By Vesa T. Kainulainen, DDS, G.K.B. Sandor, R.P. Carmichael
Journal of Oral and Maxillofacial Surgery Supplement 1 Зѓў Volume 61 Зѓў Number 8 Зѓў p41 to p41
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Abstract
Objective: The aim of this prospective study was to evaluate particulated zygomatic corticocancellous bone grafts used simultaneously with one stage dental implants to reconstruct edentulous resorbed alveolar ridges, especially with regard to the bone augmentation obtained, implant osseointegration, donor site morbidity, and patient discomfort during the postoperative healing phase.
Methods: A total of 32 patients were operated using particulated bone grafts simultaneously with one stage dental implants, in whom 82 implants were placed. Bone grafts were required for 72 of these implants. In all cases bone was harvested using a new surgical procedure and a new donor site, zygomatic bone. The bone graft was harvested from the zygoma using a custom-made bone collector. The volume of the bone graft obtained was measured. Local anesthesia with sedation was used in 27 cases and general anesthesia in 5 cases. Possible intraoperative complications were recorded. Morbidity and complications were recorded on follow-up visits. Implant success and outcome of the bone grafts were examined prospectively.
Results: As a harvest site, the zygoma yielded sufficient quantities of bone to complete the required reconstructions in all 32 cases. In one case bone was harvested bilaterally. The average zygomatic bone graft volume was 0.90 mL (SD 0.30). Maxillary sinus perforation occurred in 11 zygoma sites. None of these patients had any postoperative problems due to the perforation. No paresthesias or other complications were noted during follow-up examinations. Mean duration of postoperative swelling was 4.5 days and patients used pain medication (acetaminophen 500 mg with 30 mg of codeine) for a mean time of 4 days. After the follow-up period of 8 to 20 months (mean 17 months), 80 of 82 implants achieved successful osseointegration (97.6% success rate). None of the bone grafts were infected or lost during the healing period.
Conclusions: Zygomatic bone is a safe intraoral harvesting donor site. The outcome of particulated zygomatic bone grafts and simultaneously placed one-stage dental implants in a prospective clinical study was excellent.