Implant rehabilitation of the edentulous posterior XXXX mandible: the sandwich osteotomy revisited.

@entity1 @entity604 @entity3202 @entity281 @entity194
PURPOSE: Treatment of the posterior @entity3202 mandible has long been a challenge in implant dentistry and maxillofacial surgery. The objective of this study was to reevaluate the safety and efficacy of the sandwich osteotomy and bone grafting in @entity1 with moderate to severe posterior mandibular @entity194 . MATERIALS AND METHODS: This retrospective study included @entity1 with an edentulous posterior mandible in which there was not enough bone above the dental nerve to insert implants at least 10 mm in length; @entity1 with adequate bone volume but with an excessive interocclusal distance at the posterior occlusal region were also included. Twenty-three @entity1 with 30 sites of moderate to severe posterior @entity194 were treated using a sandwich osteotomy above the mental nerve and an interpositioned block of autologous or allogeneic bone. Success criteria were based on the possibility of implant insertion after bone grafting. RESULTS: The average gain in height was 5.3 mm (range, 2 to 10 mm). Partial @entity604 was observed in only one @entity1 from the allogeneic graft group. @entity1 were followed for 12 to 93 months after bone grafting. No signs of @entity281 were observed. Minor dehiscence of the surgical wound occurred in four segments, but healing ultimately occurred in every @entity1 . Sixty-five implants were placed, and none were lost during follow-up. Insertion of implants of 10 mm or more in length was successfully achieved in 90.8% of the sites, and partial success (ie, bone segments suitable for insertion of shorter implants) was seen in the remaining sites. CONCLUSIONS: Moderate to severe posterior mandibular @entity194 can be successfully treated by interpositional sandwich osteotomy and bone grafting, allowing for the subsequent placement of implants and fixed prostheses in all segments.
