[Anterior mandibular bone grafts by sub-mental approach]

Area of Science:

• Oral and Maxillofacial Surgery
• Regenerative Medicine
• Dental Implantology

Background:

• Extreme osseous resorption in totally edentulous mandibles often precludes dental implant placement, even in the symphysis.
• Conventional methods may be limited by severe bone loss, necessitating alternative reconstructive strategies.

Observation:

• A novel bone graft technique utilizing a submental approach for mandibular symphysis reconstruction was employed.
• Calvarial bone grafts were affixed to the superior and/or inferior aspects of the mandibular symphysis in four patients (aged 61-81).
• The submental approach provided full exposure of the symphyseal region without intraoral intervention.

Findings:

• The surgical technique resulted in a mean bone increase of 9.3mm.
• Nineteen dental implants were successfully placed post-reconstruction (average 4.75 per patient) with no implant loss.
• Patients experienced no postoperative complications, and surgical scars were inconspicuous.

Implications:

• This submental bone grafting technique is a viable option for reconstructing severely resorbed mandibles, facilitating dental implant restoration.
• The extraoral approach minimizes the risk of graft exposure and infection, making it suitable for elderly patients with denture instability.
• This method offers a predictable and safe solution for improving the quality of life for patients with advanced mandibular atrophy.