implants - international magazine of oral implantology International Edition

_Introduction Thedentalrehabilitationofpartiallyortotallyeden- tulouspatientswithoralimplantshasbecomecommon practice with reliable long-term results.1 However, un- favourablelocalconditionsofthealveolarridgedueto atrophy,periodontaldisease,traumasequel,malforma- tion or neoplasia may cause insufficient bone volume, which may complicate the therapy of the masticatory function with dental implants.2 When alveolar ridges lack the appropriate bone volume, additional surgical reconstructiveproceduresarerequired.Thisarticlecon- cludesPartI(implants3/2013)withresults,anextensive discussionandtheconclusion. _Results Onehundredandfourretromolarbonegraftproce- dures were performed in 86 patients, 77 men and nine women, with a mean age of 37.9 (range 20.2–58.4 ±10.78 years). Of the 86 patients receiving grafts, 29 were smokers (Fig. 1). Seven patients were pre-diag- nosedwithgeneral-advancedperiodontitis,whichwas successfully treated before bone grafting and one pa- tientwithdiabetesmellitusTypeII. Twenty-twoproceduresinvolvedthemaxillaand82 themandible.Also,fifteenpatientsweretreatedmulti- ply in different alveolar sites. Regarding the alveolar crest situation, 32 cases were recorded as free-end sit- uation, 27 as multiple teeth gap and 39 as single teeth gap. These as well as the intraoral area separation are presented in Table 4. In ten patients, two bone blocks wereharvestedinonesingleaugmentationposition. Of the 104 onlay bone grafts, 81 (77.8%) were de- fined absolutely successful and 23 (22.2%) had minor adverse effects, such as incision-line dehiscence, swellingorwoundinfectionwithpusexit,ortemporary paraesthesia.Onlyeightgrafts(7.6%)insevenpatients were defined as failures (i.e. graft exposure and screw mobilization). Of all the areas with complications, 15 were defined in the donor site, 23 in the recipient area andinfourpatientsexperiencedcomplicationsinboth donorandrecipientsite. Regarding postoperative swelling following the bonegraftingprocedure,mostofthepatientssuffered aminimalfacialdeformitylastingnotlongerthanthree days.Swellingwasotherwiseanexpectedcomplication aftersurgery.Attwoweeksaftertheoperation,noneof the 86 patients reported persistent pain. There was no significantassociationbetweenperiodontitisandcom- plications (p=0.43) (Fig. 2). There was also no relation between complications or failure rates of the recipient siteandjawareas(p=0.21)(Fig.3). No major complications were observed regard to donor sites. One patient developed a wound infection with exit pus, and two patients developed an abscess, whichhadtobeopenedsurgicallyinlocalanaesthesia. I research Fig. 1_Separation of the patients in men and women, according smoking habit. Retromolar bone grafts prior to implant placement Outcomes and complications—Part II Authors_Andreas Sakkas, Carsten Winter, Frank Wilde & Alexander Schramm, Germany 06 I implants4_2013