The use of bone block allografts in sinus augmentation, followed by delayed implant placement: A case series.

PURPOSE: This article reports the clinical outcomes observed in a large number of patients receiving block bone allograft used for sinus augmentation and delayed implant placement. PATIENTS AND METHODS: In total, 28 patients (13 males) with a mean age of 49.8 ± 10.1 years (range: 33-67 years) were included in this case series. All selected patients suffered from severe alveolar ridge atrophy in the posterior maxilla and required bone augmentation procedures, followed by implant placement after 6 months. All patients were followed for 18 months after the grafting, with scheduled monthly visits and/or more frequent visits if required. The survival rates for both the bone blocks and placed implants were then evaluated. RESULTS: A total of 42 blocks and 90 implants were placed. Only one bone graft and 5 implants failed; the survival rate was 97.2% and 95.5% for the bone grafts and implants, respectively. The graft failed due to the onset of post-surgical infectious sinusitis, while in some patients' implants showed absence of osteointegration at the end of the healing phase. Of note, all failed implants were observed in heavy smokers; in all other patients, blocks and implants were successful. CONCLUSIONS: This preliminary case series suggests that the grafting of bone allograft followed by delayed implant placement may be a promising strategy for sinus augmentation. More extended and larger follow-up studies are needed to confirm this preliminary data.

The use of fresh-frozen bone in oral surgery: a clinical study of 14 consecutive cases.

BACKGROUND: Although autologous bone is considered the gold standard among the grafting materials used in implant therapy, it does have a number of drawbacks, in particular morbidity at the site of donation and the limited amount of bone available. To overcome these limitations a number of alternative bone materials have been employed in the last few years. In this study we report the results of the use of homologous fresh-frozen bone from a tissue bank in patients undergoing reconstruction of bone defects in the oral cavity. MATERIAL AND METHODS: Between June 2004 and October 2008, 14 consecutive patients underwent bone reconstruction with fresh-frozen bone from a tissue bank. Four to eight months after surgery, implants were placed in the newly formed bone. RESULTS: No problems were recorded during the post-operative course. In all cases treatment was successful and osteointegrated implants were placed in the newly formed bone after 4-8 months. All implants showed good osteointegration (100% overall success rate, mean follow-up 20 months), allowing loading with a fixed cemented prosthesis. CONCLUSIONS: Our results support the previous findings that homologous fresh-frozen bone can be considered a valid alternative to autologous bone for the reconstruction of bone defects in the oral cavity in patients undergoing implant therapy.

Fresh frozen homologous bone in oral surgery: case reports.

Intraoral bone defects may be treated using autologous grafts, homologous grafts, heterologous grafts or synthetic products. Autologous bone is now considered the gold standard for bone grafting procedures. Homologous fresh frozen bone, provided by bone banks, is frequently utilized by orthopaedic surgeons because it is considered a safe material from immunological and viral points of view. In the cases reported here, homologous bone was used to repair some osseous defects without changing the surgical protocol utilized for autologous bone procedures. The main advantages of this strategy are low morbidity, shorter surgical times, more comfort and less risk of infection for the patient as well as the greater availability of bone.