Rehabilitation of Severely Atrophic Mandible: A 3-Year Follow-Up Protocol

• Published in: The Journal of oral implantology Vol. 48; no. 6; pp. 475 - 479
• Main Authors: Del Barrio, Ricardo A Landázuri, de Souza, Edelcio Rendohl, Al Houch, Alia Oka, Marão, Heloisa F
• Format: Journal Article
• Language: English
• Published: United States Allen Press Inc 01.12.2022
• Subjects: Aged; Alveolar Ridge Augmentation - methods; Animals; Atrophy - pathology; Bone growth; Bone morphogenetic protein 2; Case reports; Cattle; Dental Implantation, Endosseous - methods; Dental Implants; Dental Prosthesis, Implant-Supported; Edentulous; Female; Follow-Up Studies; Fractures; Growth factors; Humans; Mandible; Mandible - surgery; Patients; Prostheses; Reconstructive surgery; Regeneration; Rehabilitation; Surgery; Titanium; Tomography; Treatment Outcome; Brazil; bone substitutes; bone regeneration; augmentation; edentulous jaw
• ISSN: 0160-6972; 1548-1336
• DOI: 10.1563/aaid-joi-D-20-00418

Severe bone atrophies are considered a challenge in the rehabilitation process. In clinical situations involving excessive vertical bone deficiency in edentulous mandibles, there is a risk of fracture and frequently the need for an approach that involves highly complex procedures. In this context, simultaneous three-dimensional bone reconstruction associated with rigid fixation is a viable alternative to optimize longevity and avoid failures in these cases. This clinical case report presents a technique for reconstruction of severely atrophic mandibles in an elderly female patient to allow the implant-supported prosthesis protocol. The placement of immediate implants was possible by using an intraoral approach for fixation of a titanium plate followed by guided bone regeneration in association with recombinant human bone morphogenetic protein-2, deproteinized bovine bone mineral, and titanium mesh in a 1-stage surgical procedure. There are no reports in the literature of this approach for treating of severely atrophic mandibles. This association of techniques was shown to be predictable after 3 years of follow-up. Therefore, this protocol provides safe supported-implant prosthesis rehabilitation for patients with severely atrophic mandible.