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ITALIAN JOURNAL OF MAXILLOFACIAL SURGERY
A Journal on Maxillofacial Surgery
Official Journal of the Italian Society of Maxillofacial Surgery
Rivista Italiana di Chirurgia Maxillo-Facciale 2005 January-December;16(1-3):55-62
Reconstruction of severely resorbed alveolar ridges by means of iliac onlay grafts and a titanium mesh: evaluation of the morbidity and success rate of the technique
Ramieri G. A., Stigaard Kjeldsen A., Roccuzzo M.
From the Department of Maxillofacial Surgery University of Turin, Turin, Italy
Aim. The aim of this single-centre, cohort study is to evaluate the morbidity and success of iliac bone grafts stabilized Ti-meshes, on Cawood and Howell class V and VI alveolar ridges.
Methods. Twenty-six patients requiring reconstruction before implant placement were selected for this study; 58 sites were treated in all, 47 involving the maxilla and 11 the mandible. Cortico-cancellous iliac grafts were stabilized by means of a Ti-mesh fixed with two or more 1.5 mm titanium screws. Morphological and structural aspects of the alveolar ridges were examined before surgery and after 5-6 months, through clinical examination, orthopantomography and CT scan. Complications at the recipient and donor sites, appearance of the iliac scar and referral of post surgical pain were also recorded.
Results. Healing was uneventful at the donor site in 19, and at the recipient site in 8 out of the 26 patients. For what concerns complications, only one case of maxillary sinusitis with graft loss was observed. Sufficient alveolar height was achieved in 55/58 sites and adequate width in 57/58 sites. Quality has been scored as scarce in 6 sites, good in 50 sites and excellent in 2 sites. Skeletal relationships of the reconstructed alveolar crest have been judged appropriate in 24 of the 26 patients.
Conclusion. On the basis of this prospective study, alveolar ridge reconstruction using Ti-mesh/iliac grafts can be considered a predictable technique, with a rather low morbidity. Further investigation is however required to assess clinical outcome in the long term.