Rehabilitation of war-injured patients with implants: Analysis of 442 implants placed during a 6-year period

Abstract Purpose: This retrospective study assessed the overall outcome of dental implants used for the rehabilitation of war-injured victims during the 6-year period from 1992 to 1998. Materials and Methods: Seventy-three patients suffering various maxillofacial war injuries were rehabilitated using the Branemark implant system. A total of 442 implants were placed. The patients ranged from 20 to 61 years of age, with an average age of 32 years. Two hundred fifty implants were placed in previously fractured bone, and 192 were placed in grafted bone, 28 of which were placed at the time of bone grafting. The follow-up period ranged from 12 to 72 months (average, 52 months). Results: Four hundred sixteen of 442 implants were functional and clinically symptom-free during the follow-up period. Six implants were left uncovered. Twenty implants (seven mandible, 13 maxilla) were lost (4.8%). Eleven of these were in bone grafts, and nine were in previously fractured bone. Thus, the overall success rate for the implants during the follow-up period was 95.2%. The success rate for implants placed in previously fractured, nongrafted bone was 97.6% and 92.7% for those placed in grafted bone. No implants were lost in those cases that underwent simultaneous bone grafting and implant placement. However, thread exposure was more common in these cases. Conclusions: The functional results of osseointegrated implants used for rehabilitation of war-injured patients was favorable and comparable to their application in otherwise normal edentulous patients. However, a higher overall failure rate was found with implants placed in the maxilla and those placed in grafted bone. The overall aesthetic results were also less favorable in these cases because of the longer abutments required to fill the interarch space and also the subsequent resorption inherent to grafted bone, which resulted in thread exposure.