Endosseous implants for functional masticatory rehabilitation in the extremely atrophied edentulous maxilla

Abstract

The aim of this retrospective study was to evaluate the long-term survival rate of dental implants in edentulous patients suffering from severe atrophy of the alveolar ridges in the upper jaw. In total, 964 implants were inserted in 140 patients. A total of 481 implants were combined with an osteoplastic augmentation of the maxilla, and 483 implants were inserted directly in the atrophic bone. The success rate was determined using survival analysis, log rank tests and a Cox regression analysis. The overall survival rate for all implants was 42.2% during an observation period of 11 years. Between implants combined with an osteoplasty and implants inserted in local bone tissue there were no significant differences in the survival rate. The survival rate of implants combined with an osteoplasty was significantly reduced in women and in the case of repeated insertion or augmentation. Interestingly, a few of the patients treated with an osteoplasty demonstrated high numbers of individual implant failures. Those patients were postmenopausal women exclusively. Among them there is probably a certain group with a very high risk of implant failures. This study shows that oral rehabilitation with osteointegrated implants in patients with severely atrophic alveolar ridges in the upper jaw is still problematic.