Results after mandibular ridge augmentation with laminated split ribs, pedicled anterior bone lid and simultaneous...

The early results of a combined method of augmentation for extreme mandibular atrophy (Farmand, 1986) are evaluated in 40 patients over a period of up to 12-15 months after operation. The method combines the advantages of the classic augmentation procedure with laminated split ribs (Obwegeser, 1967, 1977) with those of the sandwich technique (Schettler, 1976). In cases with mucosa of good quality and quantity a simultaneous lingual and vestibular sulcoplasty is performed, thus giving the patient in a single-stage operation, conditions for adaptation of well-fitting dentures. It could be shown, that during the investigation time the mean resorption rate was 7-16% of the total anterior mandibular height. In the lateral parts, the resorption is in most cases less than one third of the transplant. 10 of 15 patients without simultaneous sulcoplasties needed a secondary soft tissue procedure after 9 months. 11 of 25 patients with simultaneous sulcoplasties needed the secondary operation. There is only one patient with a residual hypoaesthesia of the mandibular nerve. Local complications were seen in 22 cases and these were treated adequately.