Vertical rebuilding of atrophic mandible with “tent-pole”-technique
Introduction – Extreme vertical atrophy of the edentulous mandible (height below 7 mm at the lowest point) challenges the conventional treatment options for prosthetic rehabilitation. “Tent pole” technique is a predictable method to rebuild the mandible with extreme vertical atrophy; the bony reconstruction is supported by four implants that function as tent poles placed anterior to the mental foramina. The implants function as tent poles to relieve the reconstruction during healing. The mandible is rebuilt through a submental incision to maintain the blood supply to the soft tissue intraorally.
Case study – A 71-year-old woman was referred to rehabilitative treatment due to extreme vertical atrophy of the mandible and lack of retention of the lower dental prosthesis. The functional problem also included a mandibular body fracture with signs of non-union 7 years after treatment. The mandible was rebuilt using autologous, posterior hip bone and BioOss. The bony reconstruction was supported by 4 Nobel Active implants. The treatment proceeded without complications, the fracture healed and the mandibular height was increased from 5.4 mm preoperatively to 9.9 mm two years postoperatively.
Conclusion – “Tent pole” technique provides a predictable treatment result for extreme vertical atrophy, when the mandibular structural integrity is challenged. The treatment should be reserved for selected patients and should not be performed if less invasive treatments options are available.