Pedicled segmental rotation techniques for posterior mandible augmentation: a preliminary study |
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| Institution: | 1. Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran;2. Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran;3. Student Research Committee, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran;1. Department of Periodontology and Implantology, School of Dentistry, University of Santo Amaro, São Paulo, Brazil;2. Department of Periodontology and Oral Implantology, Dental Research Division, Guarulhos University, Guarulhos, SP, Brazil;3. Coordinator of Biotecnos – Tecnhology and Science, Santa Maria, Brazil;1. Resident, Oral Medicine, Diagnosis, Radiology, and Periodontology, Faculty of Dentistry, Tanta University, Alexandria, Egypt;2. Predoctoral student, Biomaterials Laboratory, Faculty of Dentistry, Alexandria University, Alexandria, Egypt;3. Predoctoral student, Biomaterials Laboratory, Faculty of Dentistry, Alexandria University, Alexandria, Egypt;4. Predoctoral student, Biomaterials Laboratory, Faculty of Dentistry, Alexandria University, Alexandria, Egypt;5. Professor, Biomaterials, Faculty of Dentistry, Alexandria University, Alexandria, Egypt;1. University Hospital Quirón Dexeus, Barcelona, Spain;2. Department of Odontoestomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, Barcelona, Spain;3. Oral Health and Masticatory System Group, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain;4. Faculty of Dentistry, University of Barcelona, Barcelona, Spain;5. Faculty of Dentistry, University of Seville, Seville, Spain |
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| Abstract: | Rehabilitation of the atrophic posterior mandible is a challenge in dental practice. Conventional treatments include the segmental sandwich osteotomy or inlay bone grafting (IBG), onlay bone grafting (OBG), short implants, distraction osteogenesis, and inferior alveolar nerve transposition (IANT), each with its downsides. This case series is reported to introduce a modification of IBG – pedicled segmental rotation (PSR) for the reconstruction of co-existing vertical and horizontal defects in the posterior mandible. Ten healthy patients with vertical–horizontal defects (no vertical bone walls and basal bone width <5 mm) were included. Posterior mandibular defects were treated with PSR, PSR + IANT, or PSR + OBG. In PSR, a pedicle-preserved segment is up-fractured superiorly and then flipped 90° to a vertical position. The segment is then supported with inorganic bovine bone and autogenous bone particulates. Cone beam computed tomography was performed preoperatively and at the 4-month follow-up, in addition to clinical examinations. Soft tissue healing was uneventful. Radiomorphometric analysis showed a mean new bone volume of 647.79 ± 81.31 mm3 (ΔH = 7.13 mm), 836.99 ± 119.14 mm3 (ΔH = 7.8 mm), and 640.20 ± 50.13 mm3 (ΔH = 6.59) in the PSR, PSR + OBG, and PSR + IANT groups, respectively. The proposed PSR technique used in this case series showed promising results for vertical and horizontal augmentation of the atrophic posterior mandible before placement of dental implants. |
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| Keywords: | alveolar bone loss dental implants bone graft inferior alveolar nerve posterior mandible |
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