MANAGEMENT OF CAWOOD AND HOWELL CLASS V AND VI BONE ATROPHIES OF THE MAXILLA WITH AUTOLOGOUS BONE GRAFTS

Rehabilitation of severe bone atrophy requires adequate bone volume. Autologous bone is the gold standard. The goals of bone grafts are a predictable formation of vital bone and the integration of implants inserted into newly formed bone. The aim of this work is to evaluate the use of autologous bone grafts in the management of severe maxillary atrophy. Fifteen patients (6 males and 9 females), with a mean age of 54.6 years, were included in the study. All 15 patients underwent onlay grafts. In 9 cases, in association with the graft, a large bilateral maxillary sinus lift was performed. In two cases, the lift was unilateral. The timing of the graft evaluations was as follows: T0 (pre-operative situation), T1 (post-operative situation), and T2 (situation 4-5 months after surgery at the time of implant placement). Radiographic and clinical measurements of the grafts demonstrated average resorption due to the phenomena of graft engraftment of 28.5% in height and 31.3% in thickness. In relation to the criteria taken into consideration, a 94% success rate was achieved in the three-dimensional rehabilitation of the upper jaw, which allowed for the prosthetically guided insertion of 85 implant fixtures.