Segmental sandwich osteotomy and tunnel technique for three-dimensional reconstruction of the jaw atrophy: a case report
Identifieur interne : 000076 ( Main/Exploration ); précédent : 000075; suivant : 000077Segmental sandwich osteotomy and tunnel technique for three-dimensional reconstruction of the jaw atrophy: a case report
Auteurs : Mario Santagata [Italie] ; Nicola Sgaramella [Italie] ; Ivo Ferrieri [Italie] ; Giovanni Corvo [Italie] ; Gianpaolo Tartaro [Italie] ; Salvatore D Mato [Italie]Source :
- International Journal of Implant Dentistry [ 2198-4034 ] ; 2017.
Abstract
A three-dimensionally favourable mandibular bone crest is desirable to be able to successfully implant placement to meet the aesthetic and functional criteria in the implant-prosthetic rehabilitation. Several surgical procedures have been advocated for bone augmentation of the atrophic mandible, and the sandwich osteotomy is one of these techniques. The aim of the present case report was to assess the suitability of segmental mandibular sandwich osteotomy combined with a tunnel technique of soft tissue. Based on our knowledge, nobody described before the sandwich osteotomy with tunnel technique to improve the healing of the wound and meet the dimensional requirements of preimplant bone augmentation in cases of a severely atrophic mandible.
A 59-year-old woman with a severely atrophied right mandible was treated with the sandwich osteotomy technique filled with autologous bone graft harvested by a cortical bone collector from the ramus. Clinical examination revealed that the mandible was edentulous bilaterally from the first molar to the second molar region. Radiographically, atrophy of the mandibular alveolar ridge in the same teeth site was observed. We began to treat the right side. A horizontal osteotomy of the edentulous mandibular bone was then made with a piezoelectric device after tunnel technique of the soft tissue. The segmental mandibular sandwich osteotomy (SMSO) was finished by two (mesial and distal) slightly divergent vertical osteotomies. The entire bone fragment was displaced cranially, and the desirable position was obtained. The gap was filled completely with autologous bone chips harvested from the mandibular ramus through a cortical bone collector. No barrier membranes were used to protect the grafts. The vertical incisions were closing with interruptive suturing of the flaps with a resorbable material. In this way, the suture will not fall on the osteotomy line of the jaw; the result will be a better predictability of soft and hard tissue healing.
Segmental mandibular sandwich osteotomy is an easy and safety technique that could be performed in an atrophic posterior mandible. Future studies involving long-term follow-up are needed to evaluate the permanence of these results.
Url:
DOI: 10.1186/s40729-017-0077-3
PubMed: 28459123
PubMed Central: 5410420
Affiliations:
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University of Campania “Luigi Vanvitelli”, Naples, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Multidisciplinary Department of Medical and Dental Specialties, Oral and Maxillofacial Surgery Unit, AOU - University of Campania “Luigi Vanvitelli”, Naples</wicri:regionArea><wicri:noRegion>Naples</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">28459123</idno><idno type="pmc">5410420</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5410420</idno><idno type="RBID">PMC:5410420</idno><idno type="doi">10.1186/s40729-017-0077-3</idno><date when="2017">2017</date><idno type="wicri:Area/Pmc/Corpus">000976</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000976</idno><idno type="wicri:Area/Pmc/Curation">000976</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000976</idno><idno type="wicri:Area/Pmc/Checkpoint">000068</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000068</idno><idno type="wicri:Area/Ncbi/Merge">006F62</idno><idno type="wicri:Area/Ncbi/Curation">006F62</idno><idno type="wicri:Area/Ncbi/Checkpoint">006F62</idno><idno type="wicri:Area/Main/Merge">000076</idno><idno type="wicri:Area/Main/Curation">000076</idno><idno type="wicri:Area/Main/Exploration">000076</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Segmental sandwich osteotomy and tunnel technique for three-dimensional reconstruction of the jaw atrophy: a case report</title><author><name sortKey="Santagata, Mario" sort="Santagata, Mario" uniqKey="Santagata M" first="Mario" last="Santagata">Mario Santagata</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Multidisciplinary Department of Medical and Dental Specialties, Oral and Maxillofacial Surgery Unit, AOU - University of Campania “Luigi Vanvitelli”, Naples, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Multidisciplinary Department of Medical and Dental Specialties, Oral and Maxillofacial Surgery Unit, AOU - University of Campania “Luigi Vanvitelli”, Naples</wicri:regionArea><wicri:noRegion>Naples</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff2">Piazza Fuori Sant′Anna 17, 81031 Aversa, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Piazza Fuori Sant′Anna 17, 81031 Aversa</wicri:regionArea><wicri:noRegion>81031 Aversa</wicri:noRegion></affiliation></author><author><name sortKey="Sgaramella, Nicola" sort="Sgaramella, Nicola" uniqKey="Sgaramella N" first="Nicola" last="Sgaramella">Nicola Sgaramella</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Multidisciplinary Department of Medical and Dental Specialties, Oral and Maxillofacial Surgery Unit, AOU - University of Campania “Luigi Vanvitelli”, Naples, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Multidisciplinary Department of Medical and Dental Specialties, Oral and Maxillofacial Surgery Unit, AOU - University of Campania “Luigi Vanvitelli”, Naples</wicri:regionArea><wicri:noRegion>Naples</wicri:noRegion></affiliation></author><author><name sortKey="Ferrieri, Ivo" sort="Ferrieri, Ivo" uniqKey="Ferrieri I" first="Ivo" last="Ferrieri">Ivo Ferrieri</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Multidisciplinary Department of Medical and Dental Specialties, Oral and Maxillofacial Surgery Unit, AOU - University of Campania “Luigi Vanvitelli”, Naples, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Multidisciplinary Department of Medical and Dental Specialties, Oral and Maxillofacial Surgery Unit, AOU - University of Campania “Luigi Vanvitelli”, Naples</wicri:regionArea><wicri:noRegion>Naples</wicri:noRegion></affiliation></author><author><name sortKey="Corvo, Giovanni" sort="Corvo, Giovanni" uniqKey="Corvo G" first="Giovanni" last="Corvo">Giovanni Corvo</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Multidisciplinary Department of Medical and Dental Specialties, Oral and Maxillofacial Surgery Unit, AOU - University of Campania “Luigi Vanvitelli”, Naples, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Multidisciplinary Department of Medical and Dental Specialties, Oral and Maxillofacial Surgery Unit, AOU - University of Campania “Luigi Vanvitelli”, Naples</wicri:regionArea><wicri:noRegion>Naples</wicri:noRegion></affiliation></author><author><name sortKey="Tartaro, Gianpaolo" sort="Tartaro, Gianpaolo" uniqKey="Tartaro G" first="Gianpaolo" last="Tartaro">Gianpaolo Tartaro</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Multidisciplinary Department of Medical and Dental Specialties, Oral and Maxillofacial Surgery Unit, AOU - University of Campania “Luigi Vanvitelli”, Naples, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Multidisciplinary Department of Medical and Dental Specialties, Oral and Maxillofacial Surgery Unit, AOU - University of Campania “Luigi Vanvitelli”, Naples</wicri:regionArea><wicri:noRegion>Naples</wicri:noRegion></affiliation></author><author><name sortKey="D Mato, Salvatore" sort="D Mato, Salvatore" uniqKey="D Mato S" first="Salvatore" last="D Mato">Salvatore D Mato</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Multidisciplinary Department of Medical and Dental Specialties, Oral and Maxillofacial Surgery Unit, AOU - University of Campania “Luigi Vanvitelli”, Naples, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Multidisciplinary Department of Medical and Dental Specialties, Oral and Maxillofacial Surgery Unit, AOU - University of Campania “Luigi Vanvitelli”, Naples</wicri:regionArea><wicri:noRegion>Naples</wicri:noRegion></affiliation></author></analytic><series><title level="j">International Journal of Implant Dentistry</title><idno type="eISSN">2198-4034</idno><imprint><date when="2017">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>A three-dimensionally favourable mandibular bone crest is desirable to be able to successfully implant placement to meet the aesthetic and functional criteria in the implant-prosthetic rehabilitation. Several surgical procedures have been advocated for bone augmentation of the atrophic mandible, and the sandwich osteotomy is one of these techniques. The aim of the present case report was to assess the suitability of segmental mandibular sandwich osteotomy combined with a tunnel technique of soft tissue. Based on our knowledge, nobody described before the sandwich osteotomy with tunnel technique to improve the healing of the wound and meet the dimensional requirements of preimplant bone augmentation in cases of a severely atrophic mandible.</p></sec><sec><title>Case presentation</title><p>A 59-year-old woman with a severely atrophied right mandible was treated with the sandwich osteotomy technique filled with autologous bone graft harvested by a cortical bone collector from the ramus. Clinical examination revealed that the mandible was edentulous bilaterally from the first molar to the second molar region. Radiographically, atrophy of the mandibular alveolar ridge in the same teeth site was observed. We began to treat the right side. A horizontal osteotomy of the edentulous mandibular bone was then made with a piezoelectric device after tunnel technique of the soft tissue. The segmental mandibular sandwich osteotomy (SMSO) was finished by two (mesial and distal) slightly divergent vertical osteotomies. The entire bone fragment was displaced cranially, and the desirable position was obtained. The gap was filled completely with autologous bone chips harvested from the mandibular ramus through a cortical bone collector. No barrier membranes were used to protect the grafts. The vertical incisions were closing with interruptive suturing of the flaps with a resorbable material. In this way, the suture will not fall on the osteotomy line of the jaw; the result will be a better predictability of soft and hard tissue healing.</p></sec><sec><title>Conclusions</title><p>Segmental mandibular sandwich osteotomy is an easy and safety technique that could be performed in an atrophic posterior mandible. Future studies involving long-term follow-up are needed to evaluate the permanence of these results.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Moura, Lb" uniqKey="Moura L">LB Moura</name></author><author><name sortKey="Carvalho, Ph" uniqKey="Carvalho P">PH Carvalho</name></author><author><name sortKey="Xavier, Cb" uniqKey="Xavier C">CB Xavier</name></author><author><name sortKey="Post, Lk" uniqKey="Post L">LK Post</name></author><author><name sortKey="Torriani, Ma" uniqKey="Torriani M">MA Torriani</name></author><author><name sortKey="Santagata, M" uniqKey="Santagata M">M Santagata</name></author><author><name sortKey="Chagas Junior, Ol" uniqKey="Chagas Junior O">OL Chagas Júnior</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="D Amato, S" uniqKey="D Amato S">S D'Amato</name></author><author><name sortKey="Tartaro, G" uniqKey="Tartaro G">G Tartaro</name></author><author><name sortKey="Itro, A" uniqKey="Itro A">A Itro</name></author><author><name sortKey="Nastri, L" uniqKey="Nastri L">L Nastri</name></author><author><name sortKey="Santagata, M" uniqKey="Santagata M">M Santagata</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Schettler, D" uniqKey="Schettler D">D Schettler</name></author><author><name sortKey="Holtermann, W" uniqKey="Holtermann W">W Holtermann</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Choi, Bh" uniqKey="Choi B">BH Choi</name></author><author><name sortKey="Lee, Sh" uniqKey="Lee S">SH Lee</name></author><author><name sortKey="Huh, Jy" uniqKey="Huh J">JY Huh</name></author><author><name sortKey="Han, Sg" uniqKey="Han S">SG Han</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Egbert, M" uniqKey="Egbert M">M Egbert</name></author><author><name sortKey="Stoelinga, Pj" uniqKey="Stoelinga P">PJ Stoelinga</name></author><author><name sortKey="Blijdorp, Pa" uniqKey="Blijdorp P">PA Blijdorp</name></author><author><name sortKey="De Koomen, Ha" uniqKey="De Koomen H">HA de Koomen</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Frost, De" uniqKey="Frost D">DE Frost</name></author><author><name sortKey="Gregg, Jm" uniqKey="Gregg J">JM Gregg</name></author><author><name sortKey="Terry, Bc" uniqKey="Terry B">BC Terry</name></author><author><name sortKey="Fonseca, Rj" uniqKey="Fonseca R">RJ Fonseca</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Jensen, Ot" uniqKey="Jensen O">OT Jensen</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Politi, M" uniqKey="Politi M">M Politi</name></author><author><name sortKey="Robiony, M" uniqKey="Robiony M">M Robiony</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Stellingsma, C" uniqKey="Stellingsma C">C Stellingsma</name></author><author><name sortKey="Raghoebar, Gm" uniqKey="Raghoebar G">GM Raghoebar</name></author><author><name sortKey="Meijer, Hj" uniqKey="Meijer H">HJ Meijer</name></author><author><name sortKey="Batenburg, Rh" uniqKey="Batenburg R">RH Batenburg</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Stoelinga, Pj" uniqKey="Stoelinga P">PJ Stoelinga</name></author><author><name sortKey="Blijdorp, Pa" uniqKey="Blijdorp P">PA Blijdorp</name></author><author><name sortKey="Ross, Rr" uniqKey="Ross R">RR Ross</name></author><author><name sortKey="De Koomen, Ha" uniqKey="De Koomen H">HA De Koomen</name></author><author><name sortKey="Huybers, Tj" uniqKey="Huybers T">TJ Huybers</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Italie</li></country></list><tree><country name="Italie"><noRegion><name sortKey="Santagata, Mario" sort="Santagata, Mario" uniqKey="Santagata M" first="Mario" last="Santagata">Mario Santagata</name></noRegion><name sortKey="Corvo, Giovanni" sort="Corvo, Giovanni" uniqKey="Corvo G" first="Giovanni" last="Corvo">Giovanni Corvo</name><name sortKey="D Mato, Salvatore" sort="D Mato, Salvatore" uniqKey="D Mato S" first="Salvatore" last="D Mato">Salvatore D Mato</name><name sortKey="Ferrieri, Ivo" sort="Ferrieri, Ivo" uniqKey="Ferrieri I" first="Ivo" last="Ferrieri">Ivo Ferrieri</name><name sortKey="Santagata, Mario" sort="Santagata, Mario" uniqKey="Santagata M" first="Mario" last="Santagata">Mario Santagata</name><name sortKey="Sgaramella, Nicola" sort="Sgaramella, Nicola" uniqKey="Sgaramella N" first="Nicola" last="Sgaramella">Nicola Sgaramella</name><name sortKey="Tartaro, Gianpaolo" sort="Tartaro, Gianpaolo" uniqKey="Tartaro G" first="Gianpaolo" last="Tartaro">Gianpaolo Tartaro</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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