Long-term Evaluation of Peri-implant Bone Level after Reconstruction of Severely Atrophic Edentulous Maxilla via Vertical and Horizontal Guided Bone Regeneration in Combination with Sinus Augmentation: A Case Series with 1 to 15 Years of Loading

Clin Implant Dent Relat Res. 2017 Feb;19(1):46-55. doi: 10.1111/cid.12431. Epub 2016 May 30.


Background: To the best of the authors' knowledge, there is very limited clinical data on the outcomes of simultaneous guided bone regeneration (GBR) for horizontal and/or vertical bone gain for the reconstruction of severely atrophic edentulous maxilla. Therefore, the purpose of the clinical series presented herein was to clinically evaluate long-term horizontal and vertical bone gain, as well as implant survival rate after reconstruction of severely atrophic edentulous maxillary ridges.

Material and methods: Sixteen patients (mean age: 64.6 ± 14.6 years of age) were consecutively treated for vertical and/or horizontal bone augmentation via GBR in combination with bilateral sinus augmentation utilizing a mixture of autologous and anorganic bovine bone. Implant survival, bone gain, intraoperative/postoperative complications and peri-implant bone loss were calculated up to the last follow-up exam.

Results: Overall, 122 dental implants were placed into augmented sites and have been followed from 12 to 180 months (mean: 76.5 months). Implant survival was 100% (satisfactory survival rate of 97.5%). Mean bone gain was 5.6 mm (max: 9 mm; min: 3 mm) While vertical bone gain was 5.1 ± 1.8 mm; horizontal bone gain was 7.0 ± 1.5 mm. No intraoperative/postoperative complications were noted. Mean peri-implant bone loss values were consistent within the standards for implant success (1.4 ± 1.0 mm). At patient-level, only one patient who had three implants presented with severe peri-implant bone loss.

Conclusion: Complete reconstruction of an atrophied maxilla can be successfully achieved by means of guided bone regeneration for horizontal and/or vertical bone gain including bilateral sinus augmentation using a mixture of anorganic bovine bone and autologous bone.

Keywords: edentulous maxilla; guided bone regeneration; horizontal ridge augmentation; maxillary reconstruction; sinus augmentation; vertical ridge augmentation.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Atrophy
  • Bone Regeneration
  • Bone Resorption / pathology*
  • Combined Modality Therapy
  • Dental Implantation, Endosseous / methods*
  • Dental Restoration Failure
  • Female
  • Follow-Up Studies
  • Guided Tissue Regeneration, Periodontal / methods*
  • Humans
  • Immediate Dental Implant Loading
  • Male
  • Maxilla / pathology*
  • Maxilla / surgery*
  • Middle Aged
  • Mouth, Edentulous / surgery*
  • Postoperative Complications / pathology*
  • Sinus Floor Augmentation / methods*