Original study - ZZI 01/2015

Clinical results of one-stage augmentation with autologous bone rings and Ankylos implants after 5 years of loading in an atrophied mandible

No associations were found between the donor region and the occurrence of postoperative complications, permitting the cautious conclusion that the donor site has no influence on the development of complications. Complications associated temporally with the procedure were more attributable to the fact that the mucosa over the bone ring and implant could not be sutured without tension, which is confirmed by the author’s previous clinical experiences [11].

In this study, the greatest mean postoperative gain in height was achieved in the anterior region, followed by the bone rings in the molar region. The lowest gain in height was found in the premolar region.

Five years postoperatively, no significant loss of height was found compared with the initial values. However, a significant difference was found over the entire group of patients without distinguishing by region. Postoperative complications depending on the insertion site were not found.

In the case of adjacent implants, no effects on the soft tissue and the course of the crestal interimplant bone was found in an animal model [2, 9], while adjacent implants led to atrophy of bone and soft tissue in humans [17]. In the present study, no associations were found between single or multiple implants placed adjacently and postoperative complications or a loss of crestal height 5 years after the procedure.

The interimplant distance is of great importance for implant success. When the distance is less than 3 mm, the risk of resorption of the crestal bone increases [29]. The influence of the interimplant distance was not investigated in the present study, however, and should be the subject of further studies.

Important parameters such as probing depths, bleeding indices and recession in the region of the implants should be recorded in further studies and should also be included in the analysis as further target variables.

Finally, further studies with greater case numbers are desirable, using a standardized measurement method for crestal bone loss in the region of the implant shoulder to ensure the internal and external validity of the study results and their reliability.


Clinical experience to date and the good long-term results of the present study show that the ring technique with autologous bone leads to low stress for the patient and to predictable results. Standardized bone harvesting and preparation with standardized trephine drills lead to a good interface between implant and bone ring. The absolutely rigid fixation of the bone ring graft with the aid of implant fixation in the basal bone enables adequate primary stability.

It therefore represents a good and practical alternative to conventional augmentation methods as both minimally inva-sive harvesting of local bone and one-stage augmentation and implant insertion are possible at the same session.

Conflict of interests: The author, Dr. Bernd Giesenhagen indicates the following potential conflicts of interest: honoraria from Dentsply Implants.

Cite as: Giesenhagen B: Klinische Fünfjahresergebnisse nach einzeitiger Augmentation mit autologen Knochenringen und Ankylos-Implantaten im atrophierten Unterkiefer. Z Zahnärztl Implantol 2015;31:52–63

DOI 10.3238/ZZI.2015.0052–0063

Correspondence address

Dr. Bernhard Giesenhagen

Praxis Dentale Implantologie

Landgraf-Karl-Str. 1

34131 Kassel

Tel.: 0561 40085362



Gemeinschaftspraxis Dr. Bernd Giesenhagen, Dr. Orcan Yüksel

Bockenheimer Landstr. 92

60323 Frankfurt/Main


1 Dental Implantology Practice, Kassel and Institute for Implantology and Aesthetic Dentistry, International continuing education center; Group practice of Dr. Bernd Giesenhagen and Dr. Orcan Yüksel; Frankfurt/Main

Übersetzung: LinguaDent

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