Rehabilitation of the edentulous maxilla with autogenous bone grafts from the iliac crest and implant-supported combined fixed restorations: a challenging task

Abstract

The rehabilitation of the edentulous maxilla with fixed implant-supported restorations is a challenging task for the clinician but very frequently demanded by patients. Prosthetically driven implant placement simplifies the design of the restoration, but severe bone resorption may prohibit the ideal positioning of implants. Bone grafting is often required to improve the bone substrate and to allow proper implant placement. The posterior maxilla can be treated by sinus floor elevation, while alveolar ridge atrophy in the anterior jaw may be improved by horizontal augmentation. The restoration must replace the missing soft and hard tissue, so the use of gingiva-coloured polymer material is often required. The objective of this article is to describe the clinical and laboratory stages of the rehabilitation of a completely edentulous patient with a fixed implant-supported prosthesis. A bilateral sinus lift and horizontal augmentation of the maxilla with bone graft from the iliac crest was performed. The prosthetic rehabilitation is also described in detail, consisting of a combination of screw-retained frameworks and cemented fixed restorations.