Novel approach for treating challenging implant-borne maxillary dental rehabilitation cases of cleft lip and palate: a retrospective study

Björn Rahlf,Philippe Korn,Simon Spalthoff,Alexander-Nicolai Zeller,Fritjof Lentge,Nils-Claudius Gellrich,Philipp Jehn

doi:10.1186/s40729-022-00401-x

Björn Rahlf, Philippe Korn + Show 5 more

Open Access

https://doi.org/10.1186/s40729-022-00401-x

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Abstract

PurposeDental restoration in cleft lip and palate (CLP) patients is demanding and often results in bone loss and dental implant failure. Furthermore, unfavorable conditions of hard and soft tissues as well as skeletal deformities aggravate surgical and dental treatment. Therefore, this study was designed to assess the feasibility of using a new type of patient-specific implant (IPS-preprosthetic®) in CLP patients.MethodsOf the 63 patients who received a IPS-preprosthetic® implant in the Department of Oral and Maxillofacial Surgery at the Hannover Medical School, Germany, six patients were treated for a CLP deformity with significant soft and hard tissue impairment. Two patients were partially edentulous, whereas four patients were edentulous for the maxilla. All implants were inserted in a single-step outpatient surgery and were followed up for up to 40 months.ResultsWithin the observation period, no implant failed and no screw loosening or change in stability of the implant to recipient site occurred (mean number of screws: 21). This study demonstrates, for the first time, the efficient use of a one-piece multivector screw primarily retained a stable patient-specific implant for implant-borne prosthodontic rehabilitation of CLP patients with deformities and challenging initial situations.ConclusionsIPS-preprosthetic® implants offer a novel approach to implant dentistry treatment protocols, especially in difficult cases of unusual anatomy, even when previous conventional treatment fails.

Highlights

Dental restoration in patients with a cleft lip and palate (CLP) remains challenging due to soft tissue and hard tissue problems resulting from congenital deformities and previous surgical treatment [1]
This study demonstrates, for the first time, the efficient use of a one-piece multivector screw primarily retained a stable patient-specific implant for implant-borne prosthodontic rehabilitation of CLP patients with deformities and challenging initial situations
IPS-preprosthetic® implants offer a novel approach to implant dentistry treatment protocols, especially in difficult cases of unusual anatomy, even when previous conventional treatment fails

Summary

Introduction

Dental restoration in patients with a cleft lip and palate (CLP) remains challenging due to soft tissue and hard tissue problems resulting from congenital deformities and previous surgical treatment [1]. Growth disturbances due to a class III skeletal angle malocclusion. Rahlf et al International Journal of Implant Dentistry (2022) 8:6. Standard treatment protocols for reestablishing dentition typically consist of four steps. The compromised and deficient bone is replaced, typically with non-vascularized bone grafting from the iliac crest. This is achieved using microvascular bone transfer from the iliac crest, fibula, or scapula. Conventional dental implants are placed into the osseointegrated bone grafts. In cases of insufficient keratinized gingiva around the implant shoulders, free mucosal grafting is performed

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