342 BONE GRAFTING PROCEDURES BEFORE IMPLANT PLACEMENT • RABELO
Retrospective Study of Bone Grafting
Procedures Before Implant Placement
Gustavo Davi Rabelo, DDS,* Priscila Marani de Paula, DDS,† Flaviana Soares Rocha, DDS,‡
Cláudia Jordão Silva, DDS, MSc, PhD,§ and Darceny Zanetta-Barbosa, DDS, MSc, PhD㛳
ental rehabilitation of partially
D or totally edentulous patients
with oral implants has become
common practice with reliable long-
term results.1 However, unfavorable lo-
cal conditions of the alveolar ridge,
because of atrophy, periodontal disease,
and trauma sequelae, may cause insuf-
ficient bone volume, which may render
implant placement impossible.2 When
the alveolar ridges lack the appropriate
bone volume, additional surgical recon-
structive procedures are required.
Researchers continuously strive to
improve on current bone grafting tech-
niques and provide faster and denser
bone regeneration. A variety of autoge-
nous,3 allogenous,4 xenogenous,5 and al-
loplastic6,7 grafts, alone or in different
combinations, have been used to pro-
vide sufficient ridge width or high for
proper positioning of endosseous im-
plants.8 –10 Additionally, the use of
platelet-rich plasma (PRP) offers a po-
tentially useful adjunct to bone grafts11
due to osteoinductive properties of
PRP.12,13
*Master Student, School of Dentistry, Uberlândia Federal
University, Minas Gerais, Brazil.
†Dental Surgeon, School of Dentistry, Uberlândia Federal
University, Minas Gerais, Brazil.
‡Master Student, School of Dentistry, Uberlândia Federal
University, Minas Gerais, Brazil.
§Assistant Professor, Oral & Maxillofacial Surgery and
Implantology Department, Uberlândia Federal University, Minas
Gerais, Brazil.
㛳Full Professor, Oral & Maxillofacial Surgery and Implantology
Department, Uberlândia Federal University, Minas Gerais, Brazil.
Reprint requests and correspondence to: Darceny Zanetta-
Barbosa, DDS, MSc, PhD, Avenida Pará s/n°, Campus
Umuarama, Bloco 4T, Departamento de Cirurgia e
Traumatologia Buco-Maxilo-Facial, Bairro Umuarama,
Uberlândia, Minas Gerais, Brazil, CEP: 38.400–902, Fax
and Telephone: 55-34-3218-2636, E-mail: ctbmf@
umuarama.ufu.br or zanetta@foufu.ufu.br
ISSN 1056-6163/10/01904-342
Implant Dentistry
Volume 19 • Number 4
Copyright © 2010 by Lippincott Williams & Wilkins
DOI: 10.1097/ID.0b013e3181e416f9
Aim: The aim of this retrospec-
tive study was to evaluate morbidity
and possible complications in aug-
mentation procedures before im-
plant placement.
Methods: Records from 93 con-
secutive patients with indication for
autogenous bone grafting before im-
plant placement, treated at Depart-
ment of Oral and Maxillofacial Surgery
and Implantology of Uberlândia Fed-
eral University, in a 7-year period
(July 2000 until July 2007), were re-
viewed. The need for bone grafting
was defined by the impossibility of in-
stalling implants of adequate length or
diameter to fulfill prosthetic require-
ments or for aesthetic reasons.
Results: A total of 136 bone graft-
ing procedures were performed. The
mandibular external oblique line and
ascending ramus were the most fre-
quently used donor areas (59.64%)
and block grafts (67.64%) were the
most frequently used type of graft,
The use of autogenous bone grafts
from intra-14 or extraoral15 donor sites
has been considered to be the gold stan-
dard in comparison with new bone graft
materials due to their biological proper-
ties and the lack of possibility of disease
transmission or host rejection.14,16,17
Complications after grafting proce-
dures are relatively rare11; however,
every surgical procedure presents ad-
vantages and disadvantages, which must
be carefully evaluated before surgery.
The clinician must make the appropriate
selection of the graft material and tech-
nique based on the size, shape, and di-
ET AL
frequently from the mandibular external
oblique line/ascending ramus (52.18%).
Platelet-rich plasma was used in 20.1%
of all procedures, usually associated
with particulate bone grafts. Maxillary
procedures represented the majority of
surgeries (75%), but with fewer compli-
cations compared with the mandible. Si-
nus mucosa perforation was the most
frequent complication in maxillary
procedures, whereas graft expo-
sure was the most common compli-
cation in mandible.
Conclusions: Alveolar recon-
struction using autogenous bone
followed by implant placement is a
reliable treatment for patients with in-
sufficient bone. Complications and
morbidity were frequently observed.
However, in only 6.6% of all proce-
dures, the final rehabilitation with
dental implants was not possible.
(Implant Dent 2010;19:342–350)
Key Words: bone graft, implant, sur-
gery, complications
mensions of the defect and its location
in the mouth.18 A guideline for surgical
decision in reconstruction for oral reha-
bilitation with implants may help pre-
vention of possible failures.
The aim of this retrospective study
was to evaluate morbidity and possible
complications in augmentation proce-
dures before implant placement.
PATIENTS AND METHODS
The records of all patients submit-
ted to implant-supported rehabilitation
at Department of Oral and Maxillofa-
 IMPLANT DENTISTRY / VOLUME 19, NUMBER 4 2010 343

cial Surgery and Implantology of Fed- mandibular external oblique line/ used in 28 procedures, representing
eral University of Uberlândia, from ascending ramus was the most fre- 20.1% of the total, usually associated
July 2000 to July 2007, were reviewed quently used donor area (59.64%) fol- with particulate bone grafts as demon-
and those who underwent bone recon- lowed by chin (20.17%) and implant strated in Table 2.
struction procedures were included in area (10.52%) as shown in Table 1. Block grafts were most frequently
the current retrospective study. Block graft were the most fre- originated from mandibular external
The need for bone grafting was de- quently used type of graft (67.64%) oblique line/ascending ramus (52.18%)
fined by the impossibility of installing and particulate grafts represented followed by calvaria (20.65%) and chin
implants of adequate length or diameter 32.34% of the procedures. PRP was (19.56%). Particulate grafts were most
to fulfill prosthetic requirements or by frequently originated from mandibular
aesthetic reasons. The following situa- Table 1. Donor Areas external oblique line/ascending ramus
tions were considered for augmentation (54.54%) followed by implant area
procedures: Number of (27.28%) and chin (13.64%) as shown
Area Procedures* (%) in Table 3.
1. Less than 5 mm of bone bellow Chin 23 (20.17) The incidence of complications
maxillary sinus. Mandibular external 68 (59.64) among the donor sites was more sig-
2. Less than 4 mm of width in poste- oblique line/ nificant for mandibular external
rior areas. ascending ramus oblique line/ascending ramus fol-
3 Vertical defects of more than 3 mm Implant area 12 (10.52) lowed by chin. Bone grafts from im-
in aesthetic area. Calvaria 9 (7.89) plant area and iliac crest did not have
Iliac crest 2 (1.75)
All patients should be in good complications (Table 4). Maxillary
Total 114 (100)
healthy conditions, without any disease augmentation procedures were the
*A total of 114 donor areas were use for 136 bone grafting
that would contraindicate surgery. All procedures performed.
majority of surgeries (102 proce-
surgeries were performed by trainee im- dures representing 75% of all), but
plantologists and supervised by a Pro- with fewer complications compared
fessor of Oral and Maxillofacial Surgery Table 2. Type of Graft and PRP Use with the mandible. Sinus mucosa
and Implantology Department. perforation was the most frequent
PRP
The pertinent data of the surgical Quantity complication in maxillary proce-
procedure were organized as follows: Type (%) Yes No dures, whereas graft exposure was
the most common complication in
Block graft 92 (67.64) 11 81
1. Donor areas: symphysis, mandibu- Particulate 44 (32.34) 17 27
the mandible. Despite the complica-
lar external oblique line/ascending graft tions, a significantly higher loss of
ramus, implant area, calvaria, and Total 136 (100) 28 108 implants was not found. The results
iliac crest. are presented in Table 5.
2. Use or not of PRP.
3. Type of graft: block graft and par- Table 3. Donor Areas and Type of Graft
ticulate bone graft.
Area Block Graft Particulate Graft
4. Transsurgical complications: graft
fracture, sinus mucosa perforation, Chin 18 (19.56) 6 (13.64)
insufficient bone at time of implant Mandibular external oblique 48 (52.18) 24 (54.54)
line/ascending ramus
installation, graft displacement, im-
Implant area 0 (0) 12 (27.28)
plant instability, and fracture of fix-
Calvaria 19 (20.65) 2 (4.54)
ation screw.
Iliac crest 7 (7.61) 0 (0)
5. Postsurgical complications: pain, Total 92 (100) 44 (100)
bleeding, infection, graft or implant
exposure, graft or implant loss, si-
nusitis, paresthesia, and hematoma.
Table 4. Number and Type of Transsurgical and Postsurgical Complications in
All patients with transsurgical or Donor Areas
postsurgical complications received
Quantity and Type
appropriate treatment. The data of all Area (Quantity) of Complications
patients were analyzed and presented
in tables. Chin (n ⫽ 23) 2 hematoma
Mandibular external oblique line/ 3 paresthesia; 1 bleeding;
ascending ramus (n ⫽ 68) 1 hematoma
RESULTS Implant area (n ⫽ 12) 0
In the 7-year period of the current Calvaria (n ⫽ 9) 1 pain
study, 136 bone grafting procedures Iliac crest (n ⫽ 2) 0
were performed in 93 patients and the Total ⫽ 114 8
344 BONE GRAFTING PROCEDURES BEFORE IMPLANT PLACEMENT • RABELO
Table 5. Number and Type of Transsurgical and Postsurgical Complications in
Receptor Areas After Bone Grafting Procedures
Area (Quantity) Specific Area (Quantity)
Mandible Anterior mandible (n ⫽ 5)
(n ⫽ 34) Posterior mandible
(n ⫽ 29)
Maxila (n ⫽ 102) Anterior maxila (n ⫽ 40) 2 graft displacement; 2 implant loss;
Posterior maxila
(n ⫽ 62)
Total 136
Table 6. Reconstructed Areas
Where Rehabilitation Was Not
Possible (n ⫽ 136)
Reason of the
Noninstallation of
the Implant Quantity (%)
Personal/financial/ 10 (7.35)
other reasons
Referred to orthodontist 3 (2.20)
Nonrehabilitation due to 9 (6.61)
insufficient bone
Total 22 (16.17)
Cases where installation of the
implants and rehabilitation were not
possible, even with bone grafting pro-
cedures and appropriate treatment for
all complications are presented in Ta-
ble 6. In 6.61% of all cases, implant
installation was not possible due to
insufficient bone after augmentation
procedures.
DISCUSSION
Implant-supported fixed or re-
movable prostheses provide a proper
treatment modality.1 Nevertheless, the
use of endosseous implants may be
limited by insufficient quality and
quantity of available bone. Several
grafting procedures have been de-
scribed to create sufficient volume of
bone for implant placement.19 Autog-
enous grafts still remain the “gold
standard” in reconstructive surgeries
due to their osteoinductive, osteocon-
ductive, and osteogenic potential14,16,17
essential for bone morphogenesis.16,17
Serra e Silva et al14 conclude that au-
togenous bone grafts are the best op-
tion compared with allografts and
Quantity and Type of Complications
0 reported to have lesser pain and dis-
5 graft exposure; 2 graft loss; 1 break of
fixation screw; 2 implant exposure; 1
graft displacement; 1 infection
1 infection
4 sinus mucosa perforation; 2 insufficient
bone during implant placement; 2
implant exposure; 1 fracture; 2
implant loss; 1 pain
29
xenografts due to its properties and
constitute a viable form of treatment
for patients with alveolar bone loss.19
Autogenous bone can be har-
vested from intra- or extraoral donor
sites. Schwartz-Arad and Levin20 con-
cluded that the intraoral bone block
grafting is a predictable operation with
a high success rate for long-span aug-
mentation. In this study, the predilection
for intraoral donor areas was based on
advantages like lower morbidity, lower
operatory cost, and easier access during
surgery.20 Other advantages include the
use of local anesthesia instead of general
anesthesia, relatively short operating
time and no need of postoperative hos-
pitalization.19 Nevertheless, complica-
tions with intraoral donor sites can
occasionally occur14 and include altered
sensation of teeth, mucosa and skin, lim-
ited mouth opening, bleeding, swelling,
pain, contour changes in donor areas,
and postoperative infections.21,22 When a
large amount of autologous bone is re-
quired for reconstruction, other areas
such as the calvaria or iliac crest, should
be considered as an alternative.15
Studies to determine which donor
sites provide sufficient bone with the
least patient discomfort and risk of
complications are needed.23 The risks
and morbidity of harvesting autoge-
nous bone from intraoral sites can be
associated with some complications,14
which do not significantly compro-
mise rehabilitation when appropriate
treatment is established. The same au-
thors also revealed that mandibular
symphysis is the intraoral donor site
with the highest prevalence of compli-
cations compared with other intraoral
ET AL
donor sites. This was not confirmed in
our study. According to Freihofer et
al,24 the mandibular symphysis is an
attractive donor site as the patients are
comfort. The main criticism for the
use of mandibular symphysis as a graft
is the limited volume of bone available
for grafting,25 thus they are not suit-
able for larger bone defects.
The mandibular external oblique
line/ascending ramus are common sites
for cortical bone harvesting21 but the
risk of damaging the inferior alveolar
nerve is of great concern when using
this technique. In our study, 3 cases of
temporary nerve paresthesia were
found. However, the number of proce-
dures in this area was high (68), and the
incidence of this complication (4.4%)
may be considered to be low even
among the trainee implantologists.
Small amounts of particulate
bone grafts may be collected from
the implant area during implant site
preparation, and the resulting bone
chips can then be used to fill small
defects or be mixed with other graft
materials. Collection of bone chips
during drilling for implant place-
ment is done under copious irriga-
tion. The main disadvantage of this
technique is the contamination with
oral bacteria. Therefore, it is sug-
gested to use 2 surgical aspirators:
one of them only for saliva and an-
other directly applied to the drilling
site, collecting only bone and saline
solution, thus reducing the risk of
excessive bacterial contamination.26
In accordance with Chiapasco et
al,2 we found that the block graft was
used in the majority of cases. Particu-
lated bone was associated with bone
blocks in case of simultaneous sinus
grafting procedures or as a filling ma-
terial around or between bone blocks.
Only bone blocks maintain the archi-
tecture of bone and appear to adapt
easily to the receptor area, whereas
particulate bone grafts must be placed
into cavities or associated with block
grafts, which limits its use for specific
clinical situations.
Higher implant failure rates have
been reported when implants are
placed into grafted sites.27 However,
in this study, despite the number of

complications, rehabilitation with oral
implants was not possible in only
6.6% of all bone grafting procedures.
Aghaloo and Moy18 have already indi-
cated similar success rates between
implants placed into grafted sited
compared with implants placed into
native bone.
Maxillary procedures represented
the majority of surgeries and presented
few complications, which could be re-
lated to the best donor site irrigation.
Sinus mucosa perforations occurred
during sinus floor elevation proce-
dures, mainly due to technical difficul-
ties. However, they were not related to
significantly higher loss of implants.
The morbidity and complication rate
of maxillary sinus augmentation re-
ported in the literature is very low.28
Raghoebar et al22 concluded that max-
illary sinus bone grafting with autog-
enous bone for the insertion of
implants is a reliable treatment modal-
ity with good long-term results.
The highest incidence of compli-
cations occurred in the mandible.
Temporary sensory disturbances and
graft exposures were the most com-
mon complications. None of them
significantly influenced the success
of rehabilitation.
When grafts are loaded and
stimulated, significant resorption
during the initial 6 months of healing
is relatively common. 9 One-stage
surgery reduces the number of sur-
gical interventions and the healing
time. However, some authors have
reported better results with the
2-stage than with the 1-stage ap-
proach.8,29 In this study, all cases
were treated by 2-staged surgeries,
allowing revascularization and in-
corporation of the graft22 in a first
moment, followed by osseointegra-
tion of the implant before prosthetic
rehabilitation, which could have
contributed to the high success rates
found. Delayed placement also per-
mits proper angulation and precise
positioning compared with implants
placed at the time of bone grafting.30
CONCLUSION
Reconstruction using autoge-
nous bone followed by implant
placement is a reliable treatment
IMPLANT DENTISTRY / VOLUME 19, NUMBER 4 2010
with high success rates. Complica-
tions and morbidity were noted in
many cases. In 6.61% of all cases,
implant installation was not possi-
ble. This retrospective study of bone
grafting surgeries can serve as a
guide in the prevention of possible
failures and consequently improve
the quality of future procedures.
ACKNOWLEDGMENT
The authors claim to have no
financial interest in any company or
any of the products mentioned in this
article.
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1141.

Abstract Translations
GERMAN / DEUTSCH
AUTOR(EN): Gustavo Davi Rabelo, DDS, Priscila Marani de
Paula, DDS, Flaviana Soares Rocha, DDS, Cláudia Jordão Silva,
DDS, MSc, PhD, Darceny Zanetta-Barbosa, DDS, MSc, PhD
Retrospektive Studie von Knochentransplantierungsa-
bläufen vor Einsetzung von Implantaten
ZUSAMMENFASSUNG: Zielsetzungen: Diese retrospe-
ktive Studie zielte darauf ab, die Sterblichkeit und möglichen
Komplikationen bei Augmentation vor Implantateinpflan-
zung zu beurteilen. Materialien und Methoden: Es wurden
die Aufzeichnungen von 93 aufeinander folgenden Patienten
mit einer Indikation für die Transplantierung von autologem
Knochengewebe vor Implantatsetzung untersucht, die in
der Abteilung für Gesichts- und Kieferchirurgie und-
implantologie an der staatlichen Universität Uberlândia in-
nerhalb eines Zeitraums von 7 Jahren (Juli 2000 bis Juli
2007) behandelt wurden. Die Notwendigkeit für eine
Knochentransplantation wurde durch die fehlenden Möglich-
keiten bestimmt, Implantate von ausreichender Länge oder
ausreichendem Durchmesser zur Erfüllung der prothetischen
Erfordernisse einsetzen zu können, oder aber durch ästhe-
tische Gründe. Ergebnisse: Insgesamt wurden 136 Knochen-
transplantierungsbehandlungen durchgeführt. Die externe
abgeschrägte Linie im Unterkiefer sowie der aufsteigende Ast
wurden am häufigsten als Spendebereich (59,64%) eingesetzt
und Blocktransplantate (67,64%) waren die am meisten eing-
esetzten Arten von Transplantaten und dies häufig von der
externen schrägen Linie im Unterkiefer / aufsteigendem Ast
(52,18%). Thrombozytreiches Plasma wurde in 20,1% aller
Fälle verwendet, normalerweise in Verbindung mit partikel-
förmigem Knochentransplantat. Die meisten chirurgischen
Eingriffe wurden im Oberkiefer abgewickelt (75%). Hierbei
gab es insgesamt trotzdem weniger Komplikationen zu ver-
zeichnen, als bei Eingriffen im Unterkiefer. Bei den Ein-
griffen im Oberkiefer war als häufigste Komplikation eine
Perforation der Sinusschleimhaut festzustellen, während
die Aufdeckung des Transplantats beim Unterkiefer
die am häufigsten auftretende Komplikation darste-
llte. Schlussfolgerungen: Eine alveolare Rekonstruktion
unter Verwendung von autogenem Knochengewebe mit
anschließender Implantateinpflanzung stellt eine zuverläs-
sige Behandlungsalternative für Patienten mit unzu-
reichendem Knochengewebe dar. Es wurden sehr häufig
Komplikationen und Sterblichkeit beobachtet. Allerdings
was in nur 6,6% aller Fälle die abschließende Wiederher-
stellung mit Zahnimplantaten überhaupt nicht möglich.
SCHLÜSSELWÖRTER: Knochentransplantat, Implantat,
Chirurgie, Komplikationen
SPANISH / ESPAÑOL
AUTOR(ES): Gustavo Davi Rabelo, DDS, Priscila Marani de
Paula, DDS, Flaviana Soares Rocha, DDS, Cláudia Jordão
Silva, DDS, MSc, PhD, Darceny Zanetta-Barbosa, DDS,
MSc, PhD
Estudio retrospectivo de procedimientos de injerto de hueso
antes de la colocación del implante
ABSTRACTO: Objetivos: El objetivo de este estudio retro-
spectivo fue evaluar la morbosidad y posibles complicaciones
en los procedimientos de aumentación antes de la colocación
del implante. Materiales y métodos: Se evaluaron los regis-
tros de 93 pacientes consecutivos con indicación de injerto
autógeno de hueso antes de la colocación del implante, trata-
dos en el Departamento de Cirugía Oral y Maxilofacial e
Implantología de la Universidad Federal Uberlândia, en un
período de 7 años (Julio/2000 hasta Julio/2007). La necesidad
 IMPLANT DENTISTRY / VOLUME 19, NUMBER 4 2010
del injerto de hueso se definió según la imposibilidad de
colocar implantes de longitud o diámetro adecuado para
cumplir los requisitos prostéticos o por razones estéticas.
Resultados: Se realizaron un total de 136 procedimientos de
injerto de hueso. La zonas de donación usadas con mayor
frecuencia fueron la línea oblicua externa de la mandíbula y
el ramo ascendente (59,64%) y los injertos de bloque
(67,64%) fueron el tipo de injerto usado con mayor frecuen-
cia, con frecuencia desde la línea oblicua externa de la
mandíbula/ramo ascendente (52,18%). Se usó plasma rico en
plaquetas en un 20,1% de todos los procedimientos, general-
mente asociados con injertos de partículas de hueso. Los
procedimientos en el maxilar representaron la mayoría de las
operaciones (75%), pero con menos complicaciones com-
parado con la mandíbula. La perforación de la mucosa del
seno fue la complicación más frecuente en los procedimientos
del maxilar mientras que el contacto con el injerto fue la
complicación más común en la mandíbula. Conclusiones: La
reconstrucción alveolar usando un hueso autógeno seguido
por la colocación del implante es un tratamiento confiable
para los pacientes con hueso insuficiente. Se observaron con
ско
frecuencia complicaciones y morbosidad. Sin embargo, en
solamente un 6,6% de todos los procedimientos, la rehabil-
ско
соолог, Flaviana Soares Rocha,
itación final con los implantes dentales no fue posible.
ско
соолог, Cláudia Jordão
PALABRAS CLAVES: Injerto de hueso, implante, cirugía,
ско
соолог, гс
complicaciones
ско
соолог, гс сс
347
rico em plaquetas em 20,1% de todos os procedimentos,
normalmente associado a enxertos de osso particulado. Os
procedimentos maxilares representaram a maioria das cirurg-
ias (75%), mas com menos complicações em comparação
com a mandíbula. A perfuração da mucosa da cavidade foi a
complicação mais frequente em procedimentos maxilares,
enquanto a exposição do enxerto foi a complicação mais
comum na mandíbula. Conclusões: A reconstrução alveolar
usando osso autógeno seguida por colocação de implante é
um tratamento confiável para pacientes com osso insufici-
ente. Complicações e morbidade foram frequentemente
observadas. Contudo, a reabilitação final com implantes
dentários não foi possível em apenas 6,6% de todos os
procedimentos.
PALAVRAS-CHAVE: Enxerto Ósseo, Implante, Cirurgia,
Complicações
RUSSIAN /

О: Gustavo Davi Rabelo, доко уг
соолог, Priscila Marani de Paula, доко
уг
доко уг
Silva, доко уг
сс ук  облс д, доко
флософ, Darceny Zanetta-Barbosa, доко
уг
ук  облс д, доко флософ
PORTUGUESE / PORTUGUÊS  оско сслдо  оду  с-
AUTOR(ES): Gustavo Davi Rabelo, Cirurgião-Dentista, л косо к  д усоко -
Priscila Marani de Paula, Cirurgiã-Dentista, Flaviana Soares л
Rocha, Cirurgiã-Dentista, Cláudia Jordão Silva, Cirurgiã-
Dentista, Mestre em Ciência, PhD, Darceny Zanetta-Barbosa, .
л. л дого оского
Cirurgiã-Dentista, Mestre em Ciência, PhD сслдо лс ок лл
Estudo retrospectivo de procedimentos de enxertamento de уло  оо осло
 ул
osso antes da colocação de implante оду  косо
к, оод
д усоко
л. л 
од .
RESUMO: Objetivos: O objetivo deste estudo retrospectivo Бл у
 д 93 ооло ооб
foi avaliar a morbidade e possíveis complicações em procedi- о с ок к уого
сл-
mentos de aumento antes da colocação de implante. Materi-  косо
к д усоко
л,
ais e Métodos: Registros de 93 pacientes consecutivos com оод  л
  одл уг
ско

indicação de enxertamento de osso autógeno antes da colo- соолог,
лсо-ло
уг  -
cação de implante, tratados no Departamento de Cirurgia лолог (Department of Oral and Maxillofacial Sur-
Oral e Maxilofacial e Implantologia da Universidade Federal gery and Implantology) ус Uberlândia Federal
de Uberlândia, num período de 7 anos (julho/2000 até julho/ University,  
 7-лго од (с л 2000 г.
2007), foram revisados. A necessidade de enxertamento ós- о л 2007 г.). !ободос  сл
seo foi definida pela impossibilidade de instalar implantes de косо
к бл обуслол ооос
comprimento ou diâmetro adequado para preencher requisitos усок ло досо
о
дл л
protéticos ou por razões estéticas. Resultados: Um total de д с л соос оод
ск
136 procedimentos de enxertamento de osso foi realizado. A бо л о "с
ск 
.
linha mandibular externa oblíqua e o ramo ascendente foram
ул . # об
слоос бло одо 136
as áreas doadoras mais frequentemente usadas (59,64%) e os оду сл косо
к. !у
enxertos em bloco (67,64%) foram o tipo de enxerto mais кос л  осод  

лс
frequentemente usado, frequentemente da linha mandibular бл бол
со солу дооск
externa oblíqua/ramo ascendente (52,18%). Foi usado plasma облс (59,64 %),  бло  сл (67,64
348 BONE GRAFTING PROCEDURES BEFORE IMPLANT PLACEMENT • RABELO ET AL

%) бл бол
со солу о с- İmplant yerleştirme öncesinde kemik greftleme prosedürl-
ло 
 сго блс  облс уо erinin retrospektif bir çalışması
косо л / осод  
лс
(52,18 %). Бог обо л ÖZET: Amaçlar: Bu retrospektif çalışmanın amacı, implant
сололс  20,1 % с оду, об
о yerleştirme öncesinde yapılan ogmantasyon prosedürlerinin
с с коускул кос сл- olası komplikasyonlarını ve morbiditesini değerlendirmekti.
. $оду  облс 
лсо - Gereç ve Yöntem: Uberlândia Federal Üniversitesinin Oral
у сослл бол со уг
ск ve Maksilofasiyal Cerrahi ve İmplantoloji Anabilim Dalında
о (75 %), о с   кол
со 7 yıllık bir dönemde (Temmuz 2000⬘den Temmuz 2007⬘ye
осло о с с оду  облс kadar) tedavi edilen ve implant yerleştirme işlemi öncesinde

лс. С
с осло  otojen kemik greftleme endikasyonu olan art ardına 93 has-
од оду  облс 
лс tanın kayıtları incelendi. Protez koşullarını karşılamak ya da
бл фо слсо оболо
к у,  estetik nedenlere cevap vermek için yeterli uzunluk ve çapta
с сос осло  implant yerleştirmenin imkansız olması kemik greftleme
од оду  облс 
лс gereksinimi olarak tanımlandı. Bulgular: Toplam 136 kemik
бло об сл.  од . greftleme prosedürü yapıldı. En sık kullanılan (%59.64) do-
&косук лолого гб с nör yerler mandibüler eksternal oblik hat ve asendan ramus
соло уого кос с ослду olup, blok greft (%67.64) en sık kullanılan greft türü idi. Bu
усоко сл лс д greft sıklıkla mandibüler eksternal oblik hat / asendan ramus-
одо л
 о с досо
 tan (%52.18) alındı. Prosedürlerin %20.1⬘inde genellikle par-
об'о косо к. Осло  tikülat kemik greftleri ile bağlantılı olan trombositten zengin
лл ул блдлс
со. plazma kullanıldı. Maksiller prosedürler cerrahi işlemlerinin
Одко олко  6,6 % с оду ол çoğunluğunu oluşturdu (%75) ve alt çeneye kıyasla daha az
бл о с уб л komplikasyona neden oldu. Maksiller prosedürlerde en sık
бл ооо . komplikasyon sinüs mukozasının perforasyonu iken, alt
КЛ СЛО
: кос сл, - çenede en yaygın komplikasyonun greftin açığa çıkması
л, уг
ск о, осло olduğu görüldü. Sonuç: Kemik yetersizliği olan hastalarda
otojen kemik kullanarak alveoler rekonstrüksiyon yapılması
ve ardından implant yerleştirilmesi güvenilir bir tedavi şek-
TURKISH / TÜRKÇE lidir. Komplikasyonlar ve morbidite sık bir şekilde gözlendi.
Ancak, tüm prosedürlerin sadece %6.6’sında dental implant
YAZARLAR: Gustavo Davi Rabelo, DDS, Priscila Marani de ile nihai rehabilitasyon sağlanamadı.
Paula, DDS, Flaviana Soares Rocha, DDS, Cláudia Jordão
Silva, DDS, MSc, PhD, Darceny Zanetta-Barbosa, DDS, ANAHTAR KELİMELER: Kemik grefti, İmplant, Cerrahi,
MSc, PhD Komplikasyon
 IMPLANT DENTISTRY / VOLUME 19, NUMBER 4 2010 349

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