AUTOGENOUS ONLAY BONE-GRAFTS FIXED WITH SCREW IMPLANTS FOR THE TREATMENT OF SEVERELY RESORBED MAXILLAE - RADIOGRAPHIC EVALUATION OF PREOPERATIVE BONE DIMENSIONS, POSTOPERATIVE BONE LOSS, AND CHANGES IN SOFT-TISSUE PROFILE

Thirty patients with severely resorbed edentulous maxillae underwent c ombined treatment of iliac bone onlay graft and titanium implants. The patients were followed for 3 years. They were radiographically examin ed before surgery to evaluate the bone volume at the intended implant sites. Only 13/156 implant sites were suitable for implant insertion. The bone level at the implant surfaces was evaluated after 6 months an d 1, 2, and 3 years, respectively. There was a continuing decrease of the bone level throughout the follow-up period with a mean loss of 4.9 mm after 3 years and with no difference between sexes. Twenty-six imp lants were radiographically examined before removal, and only three of these implant sites showed radiographic signs of failure. The soft-ti ssue profile was analyzed cephalometrically by the subtraction techniq ue, The upper lip generally moved inward and the apex of the nose and the columella downward and inward. The anterior facial height increase d in most of the patients, resulting in a downward and inward change o f the lower lip, the mentolabial sulcus, the soft-tissue pogonion, and the soft-tissue gnathion.