Autogenous bone graft procedures for atrophic edentulous mandibles

Area of Science:

• Oral and Maxillofacial Surgery
• Prosthodontics
• Regenerative Medicine

Background:

• Severe mandibular atrophy presents challenges for denture stability and patient comfort.
• Existing dentures, even when adequate, may not compensate for significant bone loss.
• Autogenous bone grafting is a viable option for reconstructing deficient alveolar ridges.

Purpose of the Study:

• To evaluate the efficacy of autogenous iliac crest bone grafting for augmenting the severely atrophied edentulous mandible.
• To assess the functional and subjective outcomes of mandibular augmentation in patients with denture intolerance.
• To determine the success of a combined oral surgery-prosthodontic team approach in managing these cases.

Main Methods:

• A joint oral surgery-prosthodontic team approach was used for five patients with extreme mandibular atrophy.
• Autogenous bone grafts were harvested from the iliac crest and used for mandibular augmentation via an extraoral submandibular approach.
• Post-surgical evaluation included assessment of complications and the subsequent fabrication and fitting of lower prostheses.

Main Results:

• The extraoral submandibular surgical approach resulted in few postoperative complications.
• Sulcus extension procedures were not required after surgery.
• Four out of five patients successfully received new lower prostheses within approximately three months.
• The overall results were considered successful by the surgical and prosthodontic teams, as well as the patients.

Conclusions:

• Autogenous iliac crest bone grafting is an effective method for augmenting the severely atrophied mandible.
• A collaborative surgical and prosthodontic approach facilitates successful prosthetic rehabilitation after mandibular augmentation.
• This technique improves denture tolerance and patient satisfaction in cases of extreme mandibular bone loss.