Iliac crest fresh frozen homografts used in pre-prosthetic surgery: a retrospective study
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Iliac crest fresh frozen homografts used in pre-prosthetic surgery: a retrospective study Maurizio Franco Æ Alessandro Viscioni Æ Leone Rigo Æ Riccardo Guidi Æ Giorgio Brunelli Æ Francesco Carinci
Received: 8 April 2008 / Accepted: 16 November 2008 / Published online: 2 December 2008 Ó Springer Science+Business Media B.V. 2008
Abstract In the case of severe jaw atrophy several options are available to restore the alveolar crest. Aim of the present study was to evaluate the resorption over time of homologous fresh frozen bone used to restore the alveolar ridge. Specifically factors influencing (1) graft survival, (2) type, and (3) degree of bone resorption were evaluated. One hundred and thirteen maxillae and 27 mandibles were grafted. The surgical techniques used were 102 inlay, 27 onlay, and 11 veneer. Measurements were taken on preoperative, post-operative, and follow-up radiographs. Data were processed by using three statistical methods: Kaplan–Meier algorithm, Cox regression, and curve estimation. As regards graft survival, Cox regression output showed a statistically significant effect only on surgical technique (P = 0.0312) and Kaplan–Meier algorithm demonstrated a worse outcome for veneer surgical technique (Log rank
M. Franco A. Viscioni L. Rigo Maxillofacial Unit, Civil Hospital, Castelfranco Veneto, Italy R. Guidi Department of Medicine, Surgery and Dentistry San Paolo, University of Milan, Milan, Italy G. Brunelli F. Carinci (&) University of Ferrara, Arcispedale S. Anna, Corso Giovecca, 203, 44100 Ferrara, Italy e-mail: [email protected] URL: www.carinci.org
test = 0.0242). The Curve estimation demonstrated an inverse correlation between degree of bone resorption over time, with a progressive decrease. In conclusion FFB is a reliable material for alveolar bone restoration with a predicable average of resorption. Keywords Iliac crest Fresh frozen bone Graft Pre-prosthetic surgery Bone resorption
Introduction The anatomical limitations of residual alveolar bone can cause problems for the insertion of dental implants (Carinci et al. 2005). Less-than-ideal sites can result in an esthetic and functional compromise (Carinci et al. 2005) because implant placement requires an adequate quantity and quality of bone. In many cases, however, this anatomic problem can be solved with autogenous bone grafts, which are the most predictable and successful material available (Carinci et al. 2005). Although autografts are the standard procedure for bone grafting, it is sometimes not possible to collect an adequate amount of bone from other donor sites on the same patient (Vargel et al. 2004). Moreover, autologous bone grafts have the drawback of a secondary surgery field for autograft retrieval, with increased operation time and anesthesia, and donor
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site morbidity. On the other hand, biomaterials are good but expensive, and may extrude at a later date (Gajiwala and Lobo Gajiwala 2003). So, the use of homologue bone provides a reasonable alternative to meet the need for graft material (Vargel et al
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