Rehabilitation of the Maxillary Arch After Bone Graft Using Immediate Loading With Implant-Supported Fixed Restoration

Abstract

Moderate and controlled loading environments support or enhance osteogenesis, and, consequently, a high degree of bone-to-implant contact can be acquired. This is because when osteoprogenitor cells are exposed to limited physical deformation, their differentiation into osteoblasts is enhanced. Then, some range of microstrain is considered advantageous for bone ingrowth and osseointegration. The primary stability has been considered one of the main clinical means of controlling micromotion between the implant and the forming interfacial tissue, which helps to establish the proper mechanical environment for osteogenesis. Based on the biological aspects of immediate loading (IL), the objective of this study is to present a clinical case of maxillary arch rehabilitation using immediate loading with implant-supported fixed restoration after bone graft. Ten dental implants were placed in the maxilla 6 months after the autogenous bone graft, removed from the mandible (bilateral oblique line and chin), followed by the installation of an immediate-load fixed cross-arch implant-supported restoration because primary stability was reached for 8 implants. In addition, instructions about masticatory function and how it is related to interfacial micromotion were addressed and emphasized to the patient. The reasons for the IL were further avoidance of an interim healing phase, a potential reduction in the number of clinical interventions for the patient, and aesthetic reasons. After monitoring the rehabilitation for 8 years, the authors can conclude that maxillary IL can be performed followed by a well-established treatment planning based on computed tomography, providing immediate esthetics and function to the patient even when autogenous bone graft was previously performed in the maxilla.

Facial and occlusal esthetic improvements of an adult skeletal Class III malocclusion using surgical, orthodontic, and implant treatment

“…Limitations inherent to complex oral rehabilitation include high morbidity associated with reconstructive procedures such as autogenous block bone grafts and osteopromotive techniques. 28 These procedures involve major surgical manipulations (including donor site surgery), numerous invasive interventions, and the need for subsequent soft tissue enhancement. Furthermore, final volumes and esthetic outcomes are often unpredictable, despite satisfactory graft progress.…”

Tópicos da odontologia aplicada - Volume 3

“…As esferas autólogas e os enxertos corticais compartilham três diferenças histológicas, os enxertos celulares vascularizam mais rapidamente e mais completamente do que os enxertos corticais, A substituição do osso esponjoso é inicialmente seguida pela fixação seguida por uma fase de reabsorção à medida que no enxerto cortical sofre um processo de substituição inverso. Os enxertos corticais tendem a cicatrizar completamente com o tempo, enquanto os enxertos corticais permanecem uma mistura de osso necrótico e viável (MARGONAR et al, 2014).…”