Immediate loading of dental implants placed in severely resorbed edentulous mandibles reconstructed with autogenous calvarial grafts

Objective: The aim of this prospective study was to present the clinical outcome of immediately loaded dental implants placed in edentulous, severely atrophied mandibles, after reconstruction with autogenous multilayered calvarial grafts. Materials and methods: Six patients, two males and four females, aged 40–67 years (mean: 56 years) presenting with severely atrophied edentulous mandibles (Cawood and Howell class VI), were reconstructed with multilayered calvarial bone grafts placed in the intraforaminal area of the mandible. Five to 8 months afterwards, 23 dental implants were placed in the reconstructed areas (three to four implants per patient) and immediately loaded with implant-supported overdentures. Patients were followed with clinical and radiographic controls annually. Results: Recovery after the reconstruction was uneventful in all patients. All 23 implants were osseointegrated 1–3 years after the start of immediate loading. The survival and success rates of implants were 100% and 95.7%, respectively. Conclusion: Results from this study showed that immediate loading of dental implants placed in severely atrophied edentulous mandibles reconstructed with calvarial bone grafts is a predictable procedure, which permits a successful dental rehabilitation with a shortening of treatment times. In the last decade, immediate loading of dental implants has confirmed to be a reliable means for the rehabilitation of partially or totally edentulous patients (Balshi & Wolfinger 1997; Chiapasco et al. 1997, 2001; Schnitman 1997; Tarnow et al. 1997; Gatti et al. 2000; Jaffin et al. 2000; Malo` et al. 2000; Chiapasco 2004). The shortening of treatment times without jeopardizing the long-term survival of dental implants