Maxillary alveolar ridge augmentation with onlay bone-grafts and immediate endosseous implants

Management of the atrophic maxilla can be a taxing surgical problems. One treatment alternative is to use autogenous bone transplants and immediate titanium fixture implantation. Despite the extensive literature on routine implant treatment of the edentulous jaws, only very few reports have dealt with the outcome of bone graft reconstructive surgery as part of the dental implant restoration. This study presents the treatment and healing results of 8 consecutive patients, who, over a period of 2 years and 8 months, were treated using onlay iliac bone grafts to atrophic maxillary alveolar ridges with immediate implant insertion. The patients were followed for 32-64 months. 83% of the fixtures (n = 46) were well-integrated. Two fixtures in each of 2 patients were lost due to traumatic bone-graft fractures. Palpatory bone-graft volume and prosthetic function were, with the exception of 1 patient, good. Radiological examination demonstrated preservation of the major part of the vertical dimension of the grafted bone. Patient's assessment was of good aesthetics and intraoral function; 2 patients had minor phonetic problems. In conclusion, similar success to routine maxillary implant treatment can be achieved in the event of extreme maxillary bone deficiency, by bone grafting and immediate fixture insertion.