Rehabilitation of patients with severely resorbed maxillae by means of implants with or without bone grafts: A 3-to 5-year follow-up clinical report

Forty-three patients with severely resorbed maxillae who had been referred for implant treatment were assigned to 1 of 3 treatment options: bone graft ing and implant placement (graft group), modified implant placement with no bone grafting (trial group), or optimized complete dentures (no-implant gr oup). Sixteen, 20 and 7 patients, respectively, were assigned to the 3 grou ps. The patients have been examined annually, and at the time of this repor t they had been followed for 3 to 5 years after treatment. At the 1-year fo llow-up, 10% (22 of 221) of the implants had been lost, and at the 2-year f ollow-up, 18% of the implants had been lost (40 of 221; 25% in the graft an d 13% in the trial group); after that time, no further losses occurred. Lif e table analysis showed cumulative success rates of 82% in the graft group and 96% in the trial group after 1 year, and 74% and 87%, respectively, at the final examination after 3 to 5 years. The failure rate was higher in sm okers than in non-smokers. A substantial reduction of the grafted bone, esp ecially of onlay grafts, occurred early after grafting surgery in many pati ents. Mean marginal peri-implant bone loss was 0.6 mm during the period fro m prosthesis connection to the 1-year follow-up, and from the 1-year to the 3-year follow-up, average periimplant bone loss was 0.3 mm in the graft gr oup and 0.5 mm in the trial group. The results corroborated previous findin gs that patients with severely resorbed maxillae have an increased risk of implant failure in comparison to patients with good bone quantity and quali ty. However, in this investigation, practically all implant losses occurred during the first 2 years, whereupon a steady state seemed to follow for up to 5 years after loading.