Abstract
The atrophic edentulous maxilla imposes a challenge for dental implant rehabilitation. Nasal floor augmentation (NFA) is a method of augmenting bone height in the anterior maxilla. Autogenous bone has been commonly used as graft material, with the exception of one study that utilized a bone graft substitute. Due to considerable variations in results and the focus on survival rather than success, the aim of this study is to evaluate the survival and success of implants placed in nasally grafted bone utilizing bone graft substitutes. Six patients with completely edentulous maxillae and inadequate height to support implants underwent NFA over a period of 3 yrs. The nasal floor was exposed via intraoral approach and grafted with bone graft substitutes. Twenty-four dental implants were placed, restored with a bar-retained implant-supported overdenture after a traditional healing period and were followed-up after prosthetic loading. Implant success was evaluated based on patient's satisfaction, soft tissue health, and bone levels. Bone levels were quantified radiographically based on a numerical score ranging from 1-3, where 3 represented the highest bone support. The age of patients ranged from 48-84 yrs. with a mean of 71.2 yrs. Three patients underwent NFA and simultaneous implant placement while the remaining had a mean healing period of 6.5 mo. before implant placement. Post loading follow-up ranged from 3.7-24.5 mo. with a mean of 12.1 mo. Survival rate was 100% with no failures and no complications. Patients were satisfied with form and function and had healthy peri-implant soft tissue with the exception of one patient who demonstrated gingival recession and thread exposure. Bone scores ranged from 2-3 with 79.2% having a score of 3 and 20.8% having a score of 2. The use of bone substitutes for NFA, as shown in this case series, is a reliable method for reconstruction of the anterior atrophic maxilla for implant-supported overdentures.
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