Outcomes of calvarial bone grafting for alveolar ridge reconstruction

This article describes a series of patients who underwent calvarial bone grafting (CBG) for reconstruction of extremely edentulous jaws for the purpose of implant placement.

A retrospective review was conducted of all patients treated with split CBGs to the atrophic maxilla or mandible between 1999 and 2006. All patients were monitored for signs of infection, dehiscence, or other complications. The amount of augmentation was measured on panoramic radiographs.

A total of 15 reconstructed sites (eight maxillary, seven mandibular) in 13 consecutive patients with a mean preoperative height of 6 mm (range, 3 to 9 mm) were included in the study and followed for a mean of 32 months. Ten women and three men aged 40 to 88 years (mean, 63 years) underwent surgery. There were no complications associated with the bone harvesting technique, and all implants had primary stability at the time of placement. Two patients had graft exposure in the maxilla. Two implants were removed in one patient. On average, the gain in ridge height was 15 mm (range, 10 to 19 mm). A total of 53 implants were placed, with an average of four implants per patient.

Split CBGs to the atrophic maxilla and mandible can restore optimal height to support and facilitate implant-based restorations. A prospective study with a longer follow-up period is required to evaluate the rate of resorption associated with split CBG. Immediate placement of implants at the time of grafting in the mandible shortens the treatment time.