Two-stage procedure reduces bone loss in oral implants

Jun 4 2010

Researchers have found that less bone loss is experienced in an oral implant when a two-stage approach to surgery is used. Simultaneously inserted implants, which require one operation to transplant bone tissue and to insert implants into the jawbone, have shown excellent results. However, when the implants were inserted in a second operation about six months after the bone tissue grafts, crestal bone loss was reduced.

The April issue of the Journal of Oral Implantology contains a retrospective study of the implant procedure. The study compares simultaneously inserted implants with delayed implants. These second-stage implants showed a higher success rate for this prosthetic restoration process.

In recent years, implants that integrate into the jawbone have proven a successful alternative to traditional dentures to replace missing teeth. In cases where there is not enough bone tissue to anchor the implant, jawbone restoration is required. An autograft, where tissue is transplanted from one site to another on the same patient, may be used. If it is not possible to gather an adequate amount of bone, a homograft (tissue from another person), may be used for the graft material. Freeze-dried bone was used as the graft material in this study.

The study examined 81 patients with a median age of 52 years who were treated in Castelfranco Veneto, Italy, between December 2003 and December 2006. Of this group, 17 patients received grafts and 48 implants in a simultaneous operation. The other 64 patients received a total of 302 implants in a second operation a mean of six months following their graft surgeries.

Only three implants were lost, all from the simultaneously inserted implants, but this did not prove to be a significant difference to predict clinical outcome between the two methods. However, examination of crestal bone resorption around the implant's neck and specific cutoff values showed the delayed implant procedure to have better clinical outcomes by allowing less bone loss. This is important because bone quality of the host (patient) is considered to be a strong predictor for the outcome of the implants.

The full text of the article, "Reconstruction of Severely Atrophic Jaws Using Homografts and Simultaneous Implant Placement: A Retrospective Study ," is available at http://www2.allenpress.com/pdf/orim-36-02-131-139.pdf