Reconstruction of the severely atrophic edentulous maxilla using Le Fort I osteotomy with simultaneous bone graft and implant placement.

PURPOSE: This study evaluated the outcome of patients who underwent simultaneous Le Fort I osteotomy, an interpositional bone graft, and implant placement for reconstruction of the severely atrophic edentulous maxilla.

PATIENTS AND METHODS: Twenty patients operated by the same surgeon were included in the study. Patients were followed annually with clinical and radiographic examinations for an average of 33 months.

RESULTS: One hundred thirty-nine implants were initially inserted in the bone grafts at the time of Le Fort I osteotomy. Twenty-five implants (18%) failed to osseointegrate. Seventeen of the 25 implants lost were from three patients. The most significant prognostic factor appeared to be the thickness of the atrophic maxillary ridge. Twelve of the 20 patients completed prosthetic restoration, with an average follow-up of 21 months after loading. No implants were lost after loading, and all prostheses have remained stable.

CONCLUSIONS: This method of reconstruction of the severely atrophic maxilla achieves an implant survival rate of 82% while correcting the unfavorable maxillomandibular relationship commonly seen in these patients.