Prosthetic restorations with osseointegrated implants after bone grafts to correct large jaw defects caused by...

A case is reported of a 21-year-old Japanese man examined for unerupted molar teeth on the left side of both jaws. Intraoral examination revealed edentulous regions from the second premolar to the molar, with moderate atrophy of the upper alveolar ridge. A panoramic X-ray revealed eight impacted teeth. The impacted mandibular teeth were extracted through decortication and bone replacement. The impacted maxillary teeth were extracted following reflection of a mucoperiosteal flap. The large defects caused by the extractions in both jaws were filled with autogenous cancellous marrow and bone chips. Eleven months later, in the first stage of the Branemark implant procedure, fixtures were placed in the edentulous regions of both jaws, with simultaneous additional corticocancellous block onlay bone grafting in the maxilla to correct slight resorption. After another seven months, second-stage abutment surgery was performed. Occlusion was then restored through a prosthetic procedure. Next, orthodontic treatment was commenced, using the implant supported teeth as an anchor. Despite the slight resorption in the maxilla, implantation was successful and occlusion was restored in the previously edentulous regions. This suggests that application of a simultaneous corticocancellous block onlay bone graft is a valuable basis for implant procedures in the maxilla.