Deep-frozen allogeneic onlay bone grafts for reconstruction of atrophic maxillary alveolar ridges: a preliminary study

Antonio Barone, Paolo Varanini, Bruno Orlando, Paolo Tonelli, Ugo Covani
Journal of Oral and Maxillofacial Surgery 2009, 67 (6): 1300-6

PURPOSE: The purpose of this article was to evaluate the suitability of deep-frozen allograft for ridge augmentation procedures in severely atrophic maxillae and to evaluate the clinical success of dental implants inserted after grafting and before prosthetic rehabilitation.

PATIENTS AND METHODS: This study included 13 patients (3 men and 10 women) aged 36 to 65 years. All the patients selected for this study required bone augmentation procedures because of severe alveolar ridge atrophy and were scheduled for onlay bone allograft and titanium implants in a 2-stage procedure. The dental implants were inserted 5 months after grafting. The follow-up period for the implants was 6 months after placement at the second stage of implant surgery.

RESULTS: A total of 24 onlay block allografts were used to augment atrophic maxillae in 13 patients. Of the 24 onlay block allografts, 5 were scheduled for vertical alveolar ridge augmentation and the remaining 19 for horizontal alveolar ridge augmentation. Early exposure of the onlay bone graft was observed in 2 patients. All the block grafts showing early exposure had to be completely removed because of infection. All the observed complications were associated with onlay bone grafts placed to increase the vertical dimension of the alveolar ridges. Thirty-eight implants ranging in length from 10 to 15 mm were placed in the area of bone augmentation. All implants inserted achieved satisfactory primary stability. Two implants failed to integrate 6 months after placement during the second stage of surgery. The failed implants were successfully replaced without any need for additional bone grafting.

CONCLUSIONS: The use of block allografts to treat maxillary atrophy yielded successful outcomes. Moreover, the augmentation procedure allowed the insertion of implants in the grafted area 5 months after surgery. Therefore, on the basis of this preliminary study, deep-frozen bone allograft can be considered a promising treatment for severe maxillary atrophy, with more extensive follow-up studies being needed to confirm these preliminary data.

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