Preprosthetic Surgical Solutions with Onlay-Inlay Grafts in Patients with Severe Maxillary Atrophies. Tow Case Reports and Literature Review
Authors: Alessandro Acocella , Roberto Sacco , and Roberto Bertolai
Abstract: One of the most frequently occurring problems in oral implantology, especially concerning the maxilla, is the reduction of the alveolar ridge caused by bone resorption in edentulous and partially edentulous patients. A commonly employed method to treat these clinical cases is the augmentation of maxillary sinus floor. Moreover, when maxillary ridge atrophy is associated with an increased arch distance, the most appropriate treatment is a combined onlay-inlay graft technique performed by the use of cortico-cancellous bone blocks harvested from iliac crest. This rehabilitation allows, in a one-step surgery, to restore adequate bone volume for subsequent implant insertion; moreover, this treatment lets to repristinate a correct maxillo-mandibular relationship in both sagittal and vertical dimensions. In this article, the Authors present four cases of severe atrophy of maxillary ridge and illustrate the advantages of combined bone graft procedures according to the principles and methodologies suggested by literature. Particularly, the Authors suggest that endosseous implant placement, in combination with alveolar ridge augmentation made by the use of the onlay-inlay technique, improve remarkably the functionality and aesthetics in patients characterised by extreme maxillary atrophy. This article demonstrates that this technique is more predictable when it is combined with a delayed placement of implant after bone graft healing, thus, avoiding conventional removable prosthetic solutions.