Long-term follow-up of implants placed after Le Fort I osteotomy with interpositional autogenous bone grafts: a retrospective study.

Abstract

Background: Oral implantology has become a standard procedure for replacing missing teeth. However, patients with severe maxillary bone resorption often require complex surgical interventions, such as Le Fort I osteotomy with interpositional bone grafting, prior to implant placement. This study aimed to evaluate the long-term outcomes of oral implants placed following this surgical technique.

Patients and methods: The present study was two-fold. First, a retrospective review was performed using medical records and conventional panoramic radiographs from 26 patients who had undergone Le Fort I osteotomy with interpositional bone grafting and received either Astra Tech or Brånemark oral implants. Patients were followed for up to 5 years. Marginal bone loss was measured from the implant shoulder to the bone level. Implant survival and success rates were assessed, with success defined as bone loss of ≤ 2 mm during the first year and < 0.2 mm annually thereafter. Second, to assess the long-term outcomes of the two oral implant systems, all traceable patients were invited to undergo a follow-up radiographic examination up to 29 years post-treatment.

Results: The combined survival rates for Astra Tech and Brånemark oral implants were 97.0%, 94.6%, and 94.1% at 1, 2, and 3 years, respectively, with no additional implant loss observed by year 5. The overall success rate at 5 years was 56.1%, with Astra Tech implants showing a higher success rate (70.8%) compared to Brånemark implants (51.4%). Although there was no statistically significant difference in survival rates between the two systems, Astra Tech implants demonstrated significantly less marginal bone loss at both 1-year (p < 0.01) and 3-year (p = 0.021) follow-ups. For the long-term evaluation, 14 patients (54%) from the original cohort were traceable, of whom 4 patients (29%) participated in the follow-up. Among the 28 Brånemark implants assessed, none were lost, resulting in a 100% survival rate up to 29 years. The mean marginal bone loss of 2.6 ± 1.8 mm.

Conclusion: Le Fort I osteotomy with interpositional bone grafting, followed by oral implant placement and prosthetic rehabilitation, appears to be a reliable long-term treatment option for patients with severe maxillary atrophy, demonstrating favorable long-term survival-, and success rates.