Recent developments in interpositional bone-grafting of the atrophic mandible

Area of Science:

• Oral and Maxillofacial Surgery
• Regenerative Medicine
• Bone Grafting Techniques

Background:

• Atrophic mandibles present challenges for oral rehabilitation.
• Mandibular augmentation using interpositioned bone grafts is a common procedure.
• Vestibuloplasty is often performed as a secondary procedure after grafting.

Purpose of the Study:

• To evaluate the outcomes of mandibular augmentation with interpositioned bone grafts without routine vestibuloplasty.
• To assess bone resorption rates in the anterior mandible.
• To investigate the fate and resorption patterns of bone grafts in the posterior mandible.

Main Methods:

• Clinical study involving 54 patients undergoing mandibular augmentation with interpositioned bone grafts.
• Deliberate omission of routine follow-up vestibuloplasty.
• Radiographic and clinical assessment of bone graft stability and resorption.
• Evaluation of lip and chin sensibility.

Main Results:

• Reduced bone resorption observed in the anterior mandibular region.
• Less interference with lip and chin sensibility compared to traditional approaches.
• Bone graft resorption in the posterior mandible (posterior to mental foramen) showed patterns similar to subperiosteal bone grafts.
• Modified surgical techniques in the posterior region yielded encouraging results.

Conclusions:

• Avoiding routine vestibuloplasty after mandibular bone grafting may reduce anterior bone resorption and preserve neurosensory function.
• The resorption pattern of bone grafts in the posterior mandible resembles that of subperiosteal grafts.
• Surgical technique modifications can optimize outcomes for bone grafting in the atrophic mandible.