[New methods of oral rehabilitation. Combination preprosthetic surgical operations with endosseous screw implants]

New methods developed in 1987 by the author are described which make the setting of titanium screw implants also possible in extreme cases of mandibular and maxillary atrophy. We describe the first time the posterior mandibular sandwich procedure after lateralization of the alveolar nerve which is a new preprosthetic method even without setting of implants. The anterior mandibular sandwich procedure is a new combination of the Schettler-method 1976 and the placement of titanium implants with interpositioning of autologous as well as lyophilized sterilized bone or lyo-cartilage. A new development is the Le Fort I-osteotomy of the extremely atrophic maxilla with total removal of the mucosa from the floor of the sinus and its obliteration using bicortical iliac crest bones fixed by titanium screw implants (Sailer, 1989). Simultaneously the intermaxillary relation is corrected and a submucous vestibuloplasty performed. Another new method is the vertical maxillary sandwich procedure designed for the extreme narrow alveolar ridge; the method fills a gap of conventional preprosthetic procedures and can be used with bank bone and bank cartilage, but also together with titanium screw implants placed extraorally into iliac crest grafts which are squeezed between the maxillary alveolar lamellae. The bucco-labial bony lamella is pedicled to the submucous tissues and to the periosteum, a submucous vestibuloplasty is always performed. The new methods are a breakthrough in preprosthetic surgery which allow the setting of long implants in cases of severe mandibular and maxillary atrophy. Fixed and hybrid suprastructures are now possible in these cases. The aesthetic aspects are convincing.(ABSTRACT TRUNCATED AT 250 WORDS)