Augmentation of the atrophic edentulous mandible by a bilateral two-step osteotomy with autogenous bone graft to place osseointegrated dental implants

Frontal preoperative view of vertical defect.

Preoperative OPT.

(A–C) Design of the two-step osteotomy and the cranial fragment up-fractured. There are reference lines in the symphyseal area (A–C), above the mental nerve (D), 8 and 16mm distal to the foramen (E, F).

Two-step osteotomy. (A) Up-fracture of the cranial fragment, (B) bone graft interposed and (C) fixed with titanium osteosynthesis screws.

Postoperative OPT.

Second stage surgery. (A) Titanium osteosynthesis screws taken out and (B) dental implants [Biomet 3i Osseotite^® implants (West Palm Beach, FL, USA)] in place; few millimetres of vertical resorption were assessed.

Bone resorption during 4 year follow-up.

Cumulative implant success rate vs. time.

(A) Postoperative OPT of implant surgery and (B) rehabilitation with full-arch implant-supported fixed prosthesis.

(A) Profile before surgery. (B) Profile after surgery showing aesthetic facial rejuvenation.