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The transmandibular implant: from progressive bone loss to controlled bone growth
M P Powers1, H Bosker, H Van Pelt
1Department of Oral and Maxillofacial Surgery, Case Western Reserve University, Cleveland, OH 44106-4905.
Summary
Revised surgical and prosthetic protocols for transmandibular implants (TMI) successfully promoted bone growth in most patients with mandibular atrophy. This approach also arrested bone resorption, offering a solution for severe cases.
Area of Science:
- Oral and Maxillofacial Surgery
- Dental Implantology
- Regenerative Medicine
Background:
- Mandibular atrophy presents significant challenges for dental implant rehabilitation.
- Traditional implant protocols often fail to address progressive bone loss in atrophic mandibles.
Purpose of the Study:
- To evaluate the efficacy of revised surgical and prosthetic protocols for transmandibular implants (TMI) in promoting bone growth and preventing resorption.
- To assess the long-term outcomes of TMI in patients with mandibular atrophy.
Main Methods:
- A prospective study involving 146 patients undergoing TMI insertion with revised protocols.
- Surgical revisions included specific placement of transosseous posts and cortical screws.
- Prosthetic revisions involved an implant-borne prosthesis with a controlled gap in saddle areas.
- Mandibular height was measured using calipers and panoramic radiographs over 18-51 months.
Main Results:
- Bone growth was observed in 131 out of 146 patients (90%).
- Bone resorption was arrested in the remaining patients.
- Bony apposition ranged from 2 mm in mild atrophy to 9 mm in severe atrophy.
Conclusions:
- The revised TMI protocols are effective in preventing further alveolar resorption.
- These protocols successfully promote significant bone growth in patients with mandibular atrophy.
- TMI offers a viable solution for rehabilitating severely atrophic mandibles.