VERTICAL BONE AUGMENTATION OF THE ATROPHIC POSTERIOR MANDIBLE PRIOR TO IMPLANT PLACEMENT WITH THE USE OF SANDWICH OSTEOTOMY
Sufficient height and width of the alveolar ridge is a prerequisite to ensure optimal implant placement for a correct aesthetic and functional prosthetic solution with a good long-term prognosis. However, placement of implants in the atrophic posterior mandible may be impossible or difficult due to reduced distance from the top of the alveolar ridge to the upper border of the mandibular canal. Vertical alveolar ridge augmentation prior to implant placement with the use of sandwich osteotomy technique and placement of an interpositional grafting material is therefore commonly performed when the height of the alveolar ridge does not allow prosthetic rehabilitation with short or standard-length implants but permits cranial displacement of the alveolar ridge above the mandibular canal. Long-term studies and systematic reviews have revealed high survival of suprastructures and implants, limited peri-implant marginal bone loss, predictable vertical bone gain and relatively few complications following the use of sandwich osteotomy technique with an interpositional grafting material. In the present review, the current knowledge on vertical alveolar ridge augmentation of the atrophic posterior mandible with the use of sandwich osteotomy prior to implant placement is presented and the surgical procedure is illustrated.