Reconstruction of Severely Resorbed Maxilla with Biodegradable Polylactide Screws: Case Series

Purpose: After the loss of natural teeth, bone changes in the jaws begin to take place immediately. Because the alveolar bone no longer responds to stresses placed in this area by teeth and periodontal ligaments, the bone begins to resorb. In such cases, alveolar bone reconstruction followed by implant-prosthetic treatment must be considered to reestablish esthetics and function. The present study was designed to compare and evaluate the effectiveness of titanium screws and absorbable fixation systems for the fixation of autogenous onlay bone grafts in maxillary reconstruction. Materials and Methods: A total of 10 consecutive patients with severely resorbed maxillae were referred to the Oral and Maxillofacial Surgery Department at Piracicaba Dental School, Campinas State University (Sao Paulo, Brazil), for oral rehabilitation through implant placement. The bone defects were treated by autologous bone grafting from the iliac crest, which was fixed with absorbable screws. The patients were followed for a minimum of 6 months after prosthodontic work was concluded. Results: The average age of the patients in this study was 46.9 years. Two dental implants were lost during the healing period. Four absorbable screws showed an unusual tissue reaction and were lost, and 90% of patients received the planned fixed prostheses. The implant success rate was 97% at 1 year after prosthesis placement. Conclusion: Fixation with absorbable screws has been shown to be safe and predictable. The absorbable screws did not interfere with bone graft healing and dental implant osseointegration. INT J ORAL MAXILLOFAC IMPLANTS 2010;25:821-82525482182