Prognostic trend in advanced implant surgery

Implant surgery in association with bone grafting is generally considered less predictive than primary implant surgery. Many reports have been published about implant rehabilitation with bone grafts in atrophic patients. Most of these papers showed a lower implant success rate than primary implantology. The aim of this study is to verify if it's possible to warrant similar results between the two types of implantology, if such procedures are performed following effective protocols and criteria.

From 1995 to 1999, 43 severely atrophic edentulous patients were treated in our Clinic with 63 autologous bone grafts and delayed implantology; 45 patients were treated with traditional implantology. 284 fixtures were positioned. The success rate in grafted implantology versus traditional implantology was compared for every maxillary and mandibular region. Furthermore, success rate in implantology of the anterior maxilla versus the poster maxilla in grafted patients was compared. The statistical considerations were performed with c2 test (p<0.05).

The statistical analysis evidenced not significative difference in the implant success rate between grafted and not grafted patients in the anterior (p=0.23) and in the posterior maxilla (p=0.35). There was not significative difference in the implant success rate between grafted and not grafted patients in the anterior mandible (p=0.54) and in the posterior mandible (p=0.54). There was not significative difference in the implant success rate between the anterior and posterior grafted maxilla (p=0.21).

The results obtained show that if close surgical protocol is performed it is possible to obtain no prognostic difference between the two METHODS.