One-step oral rehabilitation by means of implants' insertion, Le Fort I, grafts, and immediate loading

Abstract

Purpose: In the last decade, several investigators have reported that autologous and homologous fresh frozen bones are effective materials to restore alveolar ridges before insertion of dental implants. Recently, we have used femur homograft derived from living donors. Here, we reported a 1-step oral rehabilitation of the severely resorbed maxilla by means of implants' insertion, Le Fort I osteotomy for maxillary advancement, grafts, and immediate loading.

Methods: Patients were treated with 1-step oral rehabilitation. Age, sex, implant length and diameter, tooth site, loading, and grafts were the investigated variables. Implant failure and peri-implant bone resorption were considered as predictors of clinical outcome. Kaplan-Meier algorithm and Cox regression were then performed to detect those variables statistically associated with the clinical outcome.

Results: Eighty-four implants were inserted in 11 patients. Implants were inserted to replace 22 incisors, 21 cuspids, 20 premolars, and 21 molars. The mean follow-up was 17 months. Two of 84 implants were lost (ie, survival rate = 97.6%), and no differences were detected among the studied variables. By using the 82 fixtures processed with Kaplan-Meier and Cox regression, only implant site has an impact on clinical outcome, and molars have a worse outcome than incisors.

Conclusion: One-step oral rehabilitation can be used in selected patients. It significantly shortened the time of rehabilitation without adverse effects. Femur homograft derived from living donors is a valuable material for grafting jaw: it is safer, cheap, and available in programmed amounts and avoids a second operation field.