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Oral Implantology

SOFT TISSUE TUNNEL ACCESS INTO THE MANDIBULAR MUCOSA TO OPTIMIZE THE RESULT OF LATERAL MANDIBULAR BONE GRAFTS

Case report, 41 - 51
doi: 10.11138/orl/2018.11.1.041
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Abstract
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Various diseases and conditions can cause bony defects in the maxillofacial region. Since microvascular bone graft transfers were introduced in 1970, new possibilities in reconstructive surgery have arisen. Various methods of treatment have been described for severely atrophic mandibles. These methods are: (1) the placement of four endosteal implants of short length, (2) the placement of a trans-mandibular implant (3) the placement of endosteal implants in combination with vertical distraction osteogenesis or (4) the placement of endosteal implants in combination with an onlay or interpositional bone graft.
The patient was operated on to harvest bone for dental implant insertion at the Galeazzi Institute (Milan, Italy) in August 2016. He presented high resorption of edentulous mandible. Bone from the anterior approach was harvested started with a saw, and then a chisel and mallet were used. After 6 months removal of the screws of synthesis (1 fractured is left in place). Insertion of endosseous implants After 3 months loading with mixed prosthesis (bar + overdenture) with locator.
Several Authors have reported pain on walking, weakness of the abdominal wall, frank herniation, and disturbances of gait. A few other approaches have been suggested to reduce impairments at the donor site such as taking only the inner
cortex, which will reduce the amount of bone available and its implantability. Others have suggested leaving the iliac crest and harvesting the underlying bone.
It is concluded that in treatment combining an onlay graft and simultaneous implant placement in the extremely resorbed mandible, considerable graft resorption must be anticipated.

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    doi: 10.11138/orl/2018.11.1.041
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