Reduced Arch Length as a Factor for 4-Implant Immediate Function in the Maxilla: A Technical Note and Report of 39 Patients Followed for 5 Years.

PURPOSE: To determine whether maxillary arch length deficiency treated with a V-4 implant placement method is adequate for immediate functional loading during a 5-year follow-up. MATERIALS AND METHODS: Thirty-nine patients were treated with maxillary immediate function from January 3, 2011 to February 28, 2011 and followed for a period of 5 years. Arch length after implant placement was measured retrospectively around the arch from the anterior sinus wall to the contralateral anterior sinus wall in a mid-alveolar arc on the occlusal view of the preoperative computed tomogram. Eight patients with an osseous arch length shorter than 45 mm were treated with a V-4 pattern. Thirty-one patients with an arch length longer than 45 mm were treated with an M-4 placement pattern. The aim was to determine whether immediate function with a shorter arch length could be obtained on the day of surgery using a V-4 placement and whether implant stability would persist during the 5-year follow-up. Any surgical events, including lost implants, were recorded in the charts. Late follow-up was performed by panoramic films. RESULTS: During the 2-month treatment period, 39 patients (8 with V-4 placement and and 31 with M-4 placement) received maxillary treatment. The 8 patients in the V-4 group had an arch length average of 36.0 mm available for osseointegration. The 31 patients in the M-4 group had an arch length average of 56.6 mm. There were 7 implant losses (and replacements) during the 5-year follow-up, 1 in the V-4 group and 6 in the M-4 group. CONCLUSION: When the arch length bone available for osseointegration is shorter than 45 mm, a V-4 placement strategy might enable successful 4-implant fixed denture support for immediate function.

Fabrication of printed titanium shells for containment of BMP-2 composite graft materials for alveolar bone reconstruction.

The engineering, design, manufacture, and rationale for use of printed titanium shells for alveolar bone reconstruction using BMP-2/ACS/allograft are described. This is proposed as a possible improvement to the current hand-configured mesh graft technique in common use today.

Angled dental implant placement into the vomer/nasal crest of atrophic maxillae for All-on-Four immediate function: a 2-year clinical study of 100 consecutive patients.

PURPOSE: To report on the use of angled implants placed into the vomer/nasal crest to support a complete-arch maxillary prosthesis. MATERIALS AND METHODS: Consecutive patients were treated with the All-on-Four concept to restore the maxillary dentition. When bone volume in the subnasal region was inadequate, angled implants were placed into the vomer/nasal crest area to support the restoration. All implants were loaded immediately. RESULTS: One hundred consecutive maxillary All-on-Four patients were treated over a period of 2 years. Four hundred six implants were placed; 12 were inserted into the vomer/nasal crest area. One year later, at definitive restoration, the 12 vomer implants were found to be osseointegrated without bone loss or instability. CONCLUSIONS: Midline maxillary bone volume at the nasal crest appeared to be a viable alternative to the lateral nasal rim when subnasal bone was deficient. Vomer implants allowed for immediate function or were sometimes used as a rescue implant when an anterior implant failed.

BMP-2/ACS/allograft for combined maxillary alveolar split/sinus floor grafting with and without simultaneous dental implant placement: report of 21 implants placed into 7 alveolar split sites followed for up to 3 years.

This report presents seven patients who were treated with combined alveolar split/sinus grafting technique and dental implants and followed for 1 to 3 years. The grafting material included bone morphogenetic protein-2 in an absorbable collagen sponge plus allograft. The procedure was successful in all patients, who received implants either simultaneously with grafting or 4 to 6 months after grafting.

Experience with bone morphogenetic protein-2 and interpositional grafting of edentulous maxillae: a comparison of Le Fort I downfracture to full-arch (horseshoe) segmental osteotomy done in conjunction with sinus floor grafting.

This paper is a retrospective report of the treatment of six patients with severely resorbed maxillae. Patients were treated, based on the amount of maxillary retrognathia, with either a Le Fort I downfracture or a "horseshoe" interpositional sandwich osteotomy, along with sinus elevation. Recombinant human bone morphogenetic protein-2 in an absorbable collagen sponge carrier was used for grafting in all patients, either alone or in combination with other grafting materials. Implants were placed and the patients were restored with fixed prostheses. Both grafting techniques are described, and the treated patients are presented.

Orthognathic and osteoperiosteal flap augmentation strategies for maxillary dental implant reconstruction.

In this article, five variations in orthognathic surgery procedures used to gain bone mass for implants are discussed: Le Fort I downgrafting, Le Fort I distraction, sub-Le Fort I interpositional sandwich grafting, segmental sandwich grafting, and the island osteoperiosteal flap approach.

Orthognathic and osteoperiosteal flap augmentation strategies for maxillary dental implant reconstruction.

In this article, 5 variations in orthognathic surgery procedures used to gain bone mass for implants are discussed: Le Fort I downgrafting, Le Fort I distraction, sub-Le Fort I interpositional sandwich grafting, segmental sandwich grafting, and the island osteoperiosteal flap approach.