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Long-term study of dental implants placed into alveolar cleft sites
Yoshiro Matsui1, Kohsuke Ohno, Akiko Nishimura
1Department of Oral and Maxillofacial Surgery, Yokohama City Graduate School of Medicine, Japan. ymatsui@yokohama-cu.ac.jp
Objective:
To evaluate the long-term prognosis of dental implants placed into cleft sites after bone grafting in a relatively large number of cases in order to clarify the usefulness of the modality.
Patients:
Forty-seven patients with unilateral (dental, n=32) or bilateral (n=15) clefts of the alveolar process were included in this study.
Interventions:
A total of 71 implants, including smooth- or rough-surface titanium, and hydroxyapatite (HA)-coated implants, were placed after bone grafting from the anterior iliac crest and/or mandible. The placed implants were 13 to 15 mm in length.
Main Outcome:
The follow-up period was from 21 to 120 months (average=60 months). Implant survival rates were calculated as cumulative survival. Marginal bone loss (MBL) from the implant shoulder was examined, with statistical analyses performed on the influence of simultaneous bone graft and surface characteristics.
Results:
At the end of the clinical follow-up period, all implants except one were in situ and stable. Thus, the overall survival rate was 98.6% at the end of the first year and remained the same until the end of observation. Titanium implants with smooth surfaces had the lowest MBL with almost negligible regression slope, although some implants had relatively high MBL by the end of the first year.
Conclusions:
Implant therapy in the cleft site offers a reliable option for patients. Particular attention should be focused preoperatively on whether bone volume can provide primary implant stability.