Sandwich osteotomy in atrophic mandibles: A retrospective study with a 2‐ to 144‐month follow‐up

Abstract

Objectives:The aim of the present retrospective study was to assess the long-term clinical outcome of sandwich osteotomy in pre-implant augmentation of atrophic mandible. Materials and methods:Sandwich osteotomies were performed in partially and fully edentulous mandibles of 63 consecutive patients in the present study. The vertical bone gain, graft stability, and marginal bone loss were measured radiographically.Implant survival and success rates were estimated in the follow-up ranged from 2 to 144 months (mean, 58 months). Results: A total of 75 procedures were reviewed. After an average healing time of 148 days, 220 implants were placed in 74 procedures. Perioperative complications included intraoperative fracture (1/75), transient paresthesia (18/75), wound healing disturbance (18/75), and keratinized tissue deficiency (14/75). The average vertical bone gain was 5.4 mm at the time of implant placement. Significant marginal bone loss occurred during the first 6 months, after which the resorption remained stable. The implant survival rate was estimated as 96.7%, and the success rate was 95.3%. Implant survival and success showed no significant correlation with higher age, anticoagulation therapy, cardiovascular disease, or thyroid disorder. Smoking was correlated with significant lower success rate. Conclusion: Sandwich osteotomy is a suitable augmentation procedure for atrophic mandible, allowing for implant placement with promising outcome. K E Y W O R D S atrophic mandible, interposition graft, sandwich osteotomy S U PP O RTI N G I N FO R M ATI O N Additional supporting information may be found online in the Supporting Information section at the end of the article. How to cite this article: Geng Y-M, Zhou M, Parvini P, et al. Sandwich osteotomy in atrophic mandibles: A retrospective study with a 2-to 144-month follow-up. Clin Oral Impl Res.

Sandwich osteotomy with interpositional grafts for vertical augmentation of the mandible: A meta-analysis

“…Further, a safety margin of 4-5 mm above the nerve is required and keratinized tissue deficiency which limits the bone gain to a range of 4-8 mm in posterior mandible compared to 6-10 mm in the anterior mandible. [ 18 26 ] In our review the included studies showed comparable results with autologous and bone substitutes considering implant survival. Grafts placed in between the two osteotomized fragments are better able to integrate owing to the vascularization of native bone and as such no significant difference in implant survival could be observed.…”

“…[ 28 ] The basis being the intact vascularization provided by intact lingual mucoperisoteum and two osteotomized segments above the mandibular nerve. [ 26 ] The drawbacks of other augmentation procedures led Yeung in 2005 to use this technique for vertical augmentation of posterior mandible. [ 5 ]…”

“…Vertical bone height gain is more predictable in the anterior mandible region compared to posterior areas. Geng et al [ 26 ] had a mean bone height gain of 5.9 mm compared to 4.8 mm in the posterior region. Pelo et al also had better bone height gain in the anterior region.…”

“…[ 23 ] This nerve injury can occur from nerve blocks, surgical technique, and flap elevation. [ 26 ]…”

The influence of vertical ridge augmentation techniques on peri‐implant bone loss: A systematic review and meta‐analysis

“…During the data collection, only some authors replied to the e-mails sent to collect missing data. 37,50,58,62,64,73 A total of 1268 patients, receiving 4004 implants were included.…”