RESUMO
OBJECTIVE: To assess bone thickness augmentation and implant survival in ridges with horizontal atrophy managed through split crest technique with concomitant installation of dental implants. MATERIALS AND METHODS: Thirteen patients with maxillary bone atrophy underwent surgery and had their bone thickness assessed through cone beam computed tomography 6 months pre- and postoperatively. Comparative measurements of initial and final bone height and thickness were taken using Dolphin Imaging® 11.5 software. The distance between the nasal fossa floor or the maxillary sinus and the alveolar crest determined the bone height, while the measurement of bone thickness took into account the distance between the vestibular cortical bone and the palatal cortical bone at the crest level, and at 5 mm and 10 mm from it. RESULTS: The bone height loss of 0.68 mm was statistically significant (p = 0.01). The average horizontal bone gain was 3.45 mm at ridge level, 3.03 mm at 5 mm from it and 2.42 mm at 10 mm from it. The mean horizontal gain for the three regions was 2.97 mm, and the values were statistically significant for all three regions assessed (p < 0.01). No complications were associated with the surgical procedures, and 23 implants were installed following the surgical expansion. No implants were lost (100% survival). CONCLUSION: The split crest technique proved to be viable and predictable, enabling a significant increase in ridge thickness and a high percentage of implant survival.
RESUMO
The aim of this study was to analyze the survival of dental implants installed in maxillae reconstructed with autogenous iliac crest grafts and to assess patient satisfaction with the treatment by means of a questionnaire. The study conducted medical record reviews and clinical/radiographic assessments of 10 patients with severe maxillary atrophy who had undergone reconstruction with autogenous iliac crest grafts and rehabilitation with dental implants between 2008 and 2011. Patients were assessed for the survival of the implants, considering implant diameter and length, smoking status, diagnosis of diabetes, type of loss, and region of implant loss. In addition, a questionnaire with specific questions on the patients' satisfaction with the treatment was administered. Seventy-six implants were installed in the sampled patients, and only 1 loss was observed (late loss in the anterior maxilla region) after an average follow-up of 7.9 years, which corresponds to a 98.60% survival rate. The installed implants were of the most frequently used dimension (3.75 × 10 mm). One sampled patient was diabetic, and a second patient was both diabetic and a smoker. No loss of implants was observed in these 2 patients. All patients reported being completely satisfied with the treatment and would undergo the procedure again or refer it to a friend/relative. Six patients reported regular maintenance of the prosthesis, and only 3 had changed the prosthesis prior to the time of questionnaire administration. The results of this limited study with a restricted sample population suggest that the reconstruction of the maxilla with an autogenous iliac crest graft provides both adequate implant survival and patient satisfaction.