Total lower face bony rejuvenation

The technique of using a composite cadaver-autogenous bone graft for treatment of the severely atrophic mandible has been utilized in six patients. The full benefit of this technique can only be realized with the concomitant use of osseointegrated implants. The initial work of Marx has provided the basis for this reconstructive technique. Early follow-up to date is encouraging in that this procedure should help to avoid the severe resorption encountered with intraoral superior border grafting. It also avoids the need for a secondary soft-tissue procedure such as vestibuloplasty with skin grafting and lowering of the floor of the mouth. Patients tend to have an easier acceptance of this technique because they are not forced to endure long periods when they cannot wear any prosthesis, as was the case with the intraoral technique. Besides the obvious functional improvement in these patients, we have noted a marked psychologic change based on an improvement in self-image and self-perception. With the final construction of the prosthesis, there are improvements in the vertical dimension of the lower face. Results to date have been extremely encouraging and long-term follow-up will continue.