One-step oral rehabilitation by means of implants' insertion, Le Fort I, grafts, and immediate loading

Purpose: Inthelastdecade,severalinvestigatorshavereportedthat autologous and homologous fresh frozen bones are effective ma- terials to restore alveolar ridges before insertion of dental implants. Recently, we have used femur homograft derived from living donors. Here, we reported a 1-step oral rehabilitation of the severely re- sorbed maxilla by means of implants’ insertion, Le Fort I osteotomy for maxillary advancement, grafts, and immediate loading. Methods: Patients were treated with 1-step oral rehabilitation. Age, sex, implant length and diameter, tooth site, loading, and grafts were the investigated variables. Implant failure and peri-implant bone re- sorption were considered as predictors of clinical outcome. Kaplan- Meier algorithm and Cox regression were then performed to detect those variables statistically associated with the clinical outcome. Results: Eighty-four implants were inserted in 11 patients. Implants were inserted to replace 22 incisors, 21 cuspids, 20 premolars, and 21 molars. The mean follow-up was 17 months. Two of 84 implants were lost (ie, survival rate = 97.6%), and no differences were de- tected among the studied variables. By using the 82 fixtures pro- cessed with Kaplan-Meier and Cox regression, only implant site has an impact on clinical outcome, and molars have a worse outcome than incisors. Conclusion: One-step oral rehabilitation can be used in selected patients. It significantly shortened the time of rehabilitation without adverse effects. Femur homograft derived from living donors is a valuable material for grafting jaw: it is safer, cheap, and available in programmed amounts and avoids a second operation field.