THE COMBINED USE OF ENDOSTEAL IMPLANTS AND ILIAC CREST ONLAY GRAFTS IN THE SEVERELY ATROPHIC MANDIBLE - A LONGITUDINAL-STUDY

Thirteen patients, who received an onlay bone graft augmentation to th eir severely atrophic mandible in combination with a simultaneous impl ant insertion, were studied prospectively. A reproducible method that allowed for accurate assessment of graft resorption, consisting of lat eral and oblique-lateral cephalometric radiographs in combination with an image analysis system, was used to assess the resorption rate in a ll patients and between subgroups of patients, according to selected p atient and treatment characteristics. Thirty implants were placed, non e of which were lost, and all patients expressed satisfaction after a mean observation period of 877 days. A mean resorption rate of 36% of the grafted bone height occurred, mainly during the first year and wit h some degree of individual variance. After three years the resorption had virtually stopped. No statistically significant differences betwe en any of the subgroups of patients could be distinguished. Peri-impla ntitis was found around eight implants in seven patients. It is conclu ded that the described surgical technique should be used only if there are stringent indications.