Assessment of the Oblique Sandwich Osteotomy for Augmentation of Posterior Atrophic Mandible

Rehabilitation of the partially or totally edentulous mandible with implant supported prosthesis has become a common practice in the last few decades. Local conditions of the edentulous ridges may be unfavorable for dental implant placement, where sufficient bony support in both the horizontal and vertical dimensions is the foundation of any successful oral rehabilitation with dental implants. Challenges include the resorpative changes of the alveolar ridge after tooth extractions and the hard tissue deficits due to chronic periodontal disease or congenitally missing teeth. Neoplasm, osteomyelitis, cysts or trauma can also compromise the situation. All these factors require the oral implantologist to create using regenerative techniques sufficient hard tissue support at the appropriate site before or during dental implant installation. Multiple bone grafting materials and techniques have been used to reconstruct the partially dentate and edentulous posterior mandibular ridges with high rates of success, these techniques include block onlay grafting technique, guided bone regeneration using membranes or meshes and distraction osteogenesis. The selection of the optimal technique depends on various factors, including the degree of the defect, the grafted bone substitute available, the medical condition of the patient and also the skill and experience of the operator. The aim of this study is to evaluate the alveolar bone volume by the CBCT after performing oblique sandwich osteotomy in conjunction with interpositional autogenous bone grafting in the atrophied posterior mandible.

Inclusion Criteria: * Partially edentulous patients with moderate to severe posterior atrophic mandibular ridges, * Sufficient alveolar bone width for implant placement (at least 7 mms), * A native alveolar bone height above the mandibular alveolar canal till the alveolar crest (measuring from 5 to 9 mms), * Adequate inter-arch space, * The site of the graft is free from any pathologic lesion as cyst, infection or tumor. Exclusion Criteria: * The patients suffering from any systemic and metabolic disease that may affect normal healing of bone and soft tissue as diabetes or osteoporosis