Sandwich osteotomy for vertical and transversal augmentation of the posterior mandible

Horizontal and vertical osteotomies carried out with a piezoelectric surgical device to obtain the cranial bone fragment.

Upfracture of the cranial bone fragment using a chisel.

Mobilisation of cranial bone fragment and the interpositional bone graft. The lateral aspect of the cranial bone fragment was elevated more than the lingual aspect.

Postoperative panoramic radiograph showing the interpositional bone graft in both sites of the mandible.

Lingual deviation of the cranial segment and placement of the interpositional bone graft obtained from the lateral oblique line.

The interpositional bone graft is stabilized with miniplates and screws.

Collagen resorbable membrane covering the graft site.

Plate removal and implant holes 12 weeks after grafting. View of the vestibular bone showing complete integration of the interpositional bone graft.