Functional and Aesthetic Rehabilitation of CLP-Patients Using Dental Implants

Methods: In a long term retrospective study we evaluated the clinical courses and outcome of 36 CLP-patients who were treated with 85 dental implants from 1990 to 2002 in the course of surgical and dental treatment, most of them following bone transplantation. At the end of the observation period the patients were evaluated clinically, radiographically and by means of a questionnaire. Implant survival was calculated by kaplan-meier-analysis.

Results: One patient with block bone grafting and simultaneous implantation lost both implants and the bone shortly after the operation. 25 patients with 63 implants reported for follow-up: One patient had been edentulous, the others partially edentulous. Ten of these had needed a single tooth restauration. In this group four implants were lost, but repeated implantation led to a successful outcome. The overall implant survival rate was 77,8 % at the end of the observation period. With exception of two patients who had lost their implants prior to prosthodontic treatment, average patient satisfaction was good to excellent.

Discussion: In many cases missing teeth in CLP-patients can be compensated by orthodontic treatment or prosthodontic measures alone. Dental implants, however, offer a chance to substitute the missing tooth without damage to the neighbouring dentition. Implantation to the bone-grafted area prevents local atrophy of the edentulous alveolus and consequently helps to preserve the transplanted bone. In atrophic edentulous patients sinus floor elevation can generate a bony base for implantation.

Conclusions: Adapted to the individual situation, dental implants offer a chance for functional and aesthetic rehabilitation of CLP patients, provided the therapy is planned thoroughly, taking orthodontic, surgical and prosthodontic aspects into consideration.