Prosthetic rehabilitation of the atrophic maxilla using pre-implant surgery and endosseous implants.

Pre-implant surgery was carried out in 20 patients with advanced atrophy of the edentulous maxilla, using autogenous bone grafts. Endosseous implants were placed after the initial healing period and these were used to retain removable overdentures. Patients were observed for up to 5 years with 15 of the 105 implants placed being lost and two remaining as sleepers. The resulting implant success rate was 84%. Three patients had to return to conventional dentures while the remaining 17 expressed a high degree of satisfaction with their implant retained prostheses. Pre-implant surgery successfully extends the scope for implant therapy by providing sufficient bone for implant placement. The survival rate of implants in these cases appears promising up to 3 years, although further data is required to confirm the effectiveness of this treatment in the long term. Implant retained overdentures are able to successfully restore both oral function and facial form. The rehabilitation of the atrophic, edentulous maxilla remains difficult and complex, even when using pre-implant surgery and implant retained prostheses.