Endosteal implants and iliac crest grafts to restore severely resorbed totally edentulous maxillae--a retrospective...

Autogenous grafts in conjunction with endosteal implants may be indicated in conditions of severe atrophy of the maxilla. From July, 1984, to December, 1990, 20 severely atrophic arches were restored with iliac crest onlay block grafts, subantral augmentation, and 148 endosteal root-form implants. Twenty-one implants were placed at the same time as the graft to stabilize a corticotrabecular bone block. Two implants were lost (90% implant survival). One hundred twenty-seven implants were placed after graft maturity, and one implant was removed (99% implant survival). Thirteen fixed restorations and 7 completely implant-supported overdentures were fabricated. Follow-up evaluation of prostheses and implants ranged from 26 to 97 months. All the implants used for initial prosthesis fabrication and all initial prostheses remain in function. The advantages of implant placement after graft maturity and subantral augmentation are addressed. One year after implant placement, the amount of additional bone lost around the implants placed in grafted bone is similar to the bone loss around maxillary implants inserted into non-grafted bone.