A long-term retrospective study of two different implant surfaces placed after reconstruction of the severely resorbed maxilla using Le Fort I osteotomy and interpositional bone grafting

Abstract

Purpose: In this retrospective study, the long-term survival and success rates of implants with 2 different surfaces placed in extremely atrophic maxillae augmented with Le Fort I osteotomy and interpositional bone grafts were assessed.

Materials and methods: In 12 consecutive patients (7 female, 5 male; average age, 55 years; age range, 47 to 63 years), the resorbed maxilla was reconstructed using Le Fort I osteotomy in combination with interpositional iliac bone grafts. After 5 to 6 months, machined or titanium plasma-sprayed implants were inserted. The patients were followed clinically and radiographically for 6 to 12 years (mean 102 +/- 24.42 months) after prosthetic loading. Implant outcome in terms of survival and success using Albrektsson's criteria was analyzed.

Results: In all cases, the bone-grafting procedures allowed implant placement. Of the 104 implants placed (53 machined and 51 titanium plasma-sprayed), 11 failed, resulting in an overall cumulative survival rate of 89.4%. When the success rate was calculated using the defined criteria, the cumulative success rate was 67.3%. The respective survival and success rates were 86.8% and 66.0% for the machined implants and 92.2% and 68.7% for the titanium plasma-sprayed implants. The mean marginal bone resorption was 2.91 +/- 0.77 mm (range, 0.6 to 4.9 mm) around machined implants and 2.72 +/- 0.84 mm (range, 0.7 to 5.3 mm) around titanium plasma-sprayed implants. No significant differences in survival, success rate, or marginal bone resorption were found between the 2 implant groups.

Conclusions: Le Fort I osteotomy combined with bone grafts and delayed implant placement gave predictable long-term results. There was a distinct relationship between implant survival and the long-term success rate. The implant surface had no significant effect on the survival, success rate, or marginal bone resorption.