Long-term retrospective evaluation of the peri-implant bone level in onlay grafted patients with iliac bone from the anterior superior iliac crest.

OBJECTIVE: The purpose of the present study was to evaluate crestal bone level changes around dental implants after iliac bone augmentation in the long term. MATERIAL AND METHODS: A total of 32 partially edentulous/edentulous patients (mean age, 52 years; range, 22-70 years) and a remaining bone volume of less than 5 mm of the alveolar ridge underwent maxillary or mandibular iliac bone graft augmentation. All patients received spaced standardized radiological examination for evaluation of peri-implant crestal bone loss. RESULTS: The grafting procedure was successfully performed in all patients. A total of 150 implants were placed. The mean observation period was 69 months (range, 12-165 months; success rate for maxilla, 96%; success rate for mandible, 92%). The mean amount of crestal bone loss after 10 years was 1.8 mm. A significant difference between gender and crestal bone loss was shown, but no influence was found regarding the implant system, diameter of implant, and age of the patients. CONCLUSION: In patients with atrophic jaws, a sufficient long-term reconstruction can be achieved with the combination of iliac onlay grafting and dental implants. The results demonstrate high success rates and a stable peri-implant bone level in the long term.

Rehabilitation of irradiated patients with chemically modified and conventional SLA implants: five-year follow-up.

The aim of this study is to evaluate the clinical and radiological parameters of standard SLA surface implants compared to chemically modified hydrophilic SLActive implants in irradiated patients after the initial 12-month loading period up to 5 years. Twenty patients with a mean age of 61·1 years were treated with dental implants after ablative surgery and radio-chemotherapy of oral cancer. All patients were non-smokers. The placement of 102 implants (50 SLA, 52 SLActive) was performed bilaterally according to a split-mouth design. Mean crestal bone changes were evaluated using standardised orthopantomographies and clinical parameters. Data were analysed using a Kaplan-Meier curve, Mann-Whitney U-test and two-factorial non-parametric analysis. The average observation period was 60 months. The amount of bone loss at the implant shoulder of SLA implants was mesial and distal 0·7 mm. The SLActive implants displayed a bone loss of mesial 0·6 mm as well as distal 0·7 mm after 5 years. Two SLA implants were lost before loading. One patient lost five implants due to recurrence of a tumour. The overall cumulative 12-month, 3-year and 5-year survival rate of SLA implants was 92%, 80% and 75·8% and of SLActive implants 94·2%, 78·8% and 74·4%, respectively. Eighteen implants were considered lost because the patients had died. Sandblasted acid-etched implants with or without a chemically modified surface can be used in irradiated patients with a high predictability of success. Lower implant survival rates in patients with irradiated oral cancer may be associated with systemic effects rather than peri-implantitis.