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The International Journal of Oral & Maxillofacial Implants
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Int J Oral Maxillofac Implants 22 (2007), No. 2     15. Mar. 2007
Int J Oral Maxillofac Implants 22 (2007), No. 2  (15.03.2007)

Page 280-288, PubMed:17465354


Augmentation of the Posterior Atrophic Edentulous Maxilla with Implants Placed in the Ulna: A Prospective Single-Blind Controlled Clinical Trial
Cannizzaro, Gioacchino / Leone, Michele / Consolo, Ugo / Ferri, Vittorio / Licitra, Giorgio / Worthington, Helen / Esposito, Marco
Purpose: To evaluate a new method to treat the posterior atrophic edentulous maxilla: dental implants placed in the ulna and transplanted with their surrounding bone blocks as inlays into the sinus. Conventional sinus augmentation with particulated autogenous bone grafts served as a control procedure.
Materials and Methods: Fifty-two implants were placed in the ulnas of 20 patients. After 6 weeks, bone blocks containing 1 to 3 implants were harvested and transplanted into the sinuses protruding 3 to 4 mm. Implants were left to heal for 6 weeks. Twenty patients with similar treatment indications treated with particulated bone grafts from the mental symphysis, tibia, or iliac crest acted as controls. Grafts were allowed to heal for 6 months in the control group. Fifty-two control-group implants were allowed to heal for 4 months. The main outcome measures were prosthetic and implant success. Stability of individual implants was assessed with Osstell and Periotest at baseline and after 6 and 12 months of loading. Independent sample chi-square tests, t tests, and paired t tests were used with a significance level of .05.
Results: No patient dropped out or withdrew; no prosthesis or implant failed. No major surgical complications were occurred. There were no differences between the 2 groups at any time point in implant stability. Both modalities resulted in a significant increase of implant stability at 6 and 12 months. The mean change (SD) from baseline to 1 year in Periotest measurements was 1.44 (0.48) in the test and 1.29 (0.58) in the control (paired t tests; P < .001). For the Osstell, these values were -5.88 (4.18) and -5.48 (3.93) for the test and control groups, respectively (paired t tests: P < .001).
Conclusions: Ulna implant block grafting represents an alternative to conventional sinus augmentation, particularly when vertical augmentation is desirable or large iliac crest grafts are needed.

Keywords: bone grafting, dental implants, sinus augmentation, ulna