Implant-supported restoration of congenitally missing teeth using cancellous bone block-allografts

Background and objective. Patients with congenitally missing teeth may present with undeveloped alveolar bone morphology, making implant reconstruction a challenge. The aim of the present study was to evaluate the outcome of dental implants after ridge augmentation with cancellous freeze-dried block bone allografts in patients with congenitally missing teeth. Study design. Twelve patients with a mean age of 21 +/- 4 years, were included. Congenitally missing teeth included maxillary lateral incisors, a maxillary canine, and mandibular central and lateral incisors. A bony deficiency of >= 3 mm horizontally and <= 3 mm vertically according to computerized tomography served as inclusion criteria. Twenty-one implants were inserted after a healing period of 6 months. Five out of 21 implants were immediately restored. Bone measurements were taken before bone augmentation, during implant placement, and at second-stage surgery. Results. Nineteen cancellous allogeneic bone-blocks were used. The mean follow-up time was 30 +/- 16 months. Bone block and implant survival rates were 100% and 95.2%, respectively. Mean bone gain was statistically significant (P < .001): 5 +/- 0.5 mm horizontally and 2 +/- 0.5 mm vertically. All of the patients received a fixed implant-supported prosthesis. Soft tissue complications occurred in 4 patients (30%). Complications after cementation of the crowns were seen in 1 implant (4.8%). All implants remained clinically osseointegrated at the end of the follow-up examination. There was no crestal bone loss around the implants beyond the first implant thread. Conclusion. Cancellous bone block-allografts can be used successfully for implant-supported restorations in patients with congenitally missing teeth. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011;111:286-291)