Implant Placement in Three-Dimensional Grafts in the Anterior Jaw

A series of 12 men and 13 women ranging in age from 24 to 71 years underwent two- or three-dimensional reconstruction of type C, D, or E ridges and placement of anterior implants. The mean horizontal augmentation was 6.4 mm (range 2 to 17 mm), and the mean vertical augmentation was 4.22 mm (range 0 to 15 mm). The 67 implants were all loaded, with the time averaging 34.4 months for the maxillary implants and 19 months for the mandibular implants. None of the implants have been lost to date. Two patients had flap retraction within the first 2 weeks that necessitated reapproximation. One patient had total failure of a J graft of iliac crestal bone from the maxillary left central incisor to canine starting 3 weeks after placement as the result of infection. The graft was removed at 6 weeks, and no implants were placed. Two patients suffered partial anterior graft loss, but their implants were successful in location and angulation. Implants and grafts can be combined with acceptable rates of complications and failure.