Dynamic Navigated “Sandwich” Technique: A Novel Surgical Approach for Safe Osteotomies in the Rehabilitation of an Atrophic Posterior Mandible: A Case Report

Abstract

A 56-year-old female patient with vertical atrophy of the right posterior mandible was treated adopting an interpositional bone block approach using a cancellous heterologous bone block. Osteotomies of the patient’s mandible were performed with the help of dynamic computer-assisted surgery using virtual anatomical patient information obtained from a cone beam computed tomography (CBCT). The use of the dynamic computer-assisted surgery allowed authors to perform the horizontal osteotomy line as planned preoperatively on the CBCT virtual reconstruction, trying to minimize the risks of the inlay technique. No neurological complications were observed after surgery. The inlay technique could benefit from the aid of dynamic navigation technologies in posterior atrophic mandibles, increasing the reproducibility of the technique. A likely safer method for performing osteotomies with the “sandwich” technique in the posterior atrophic mandible is reported.

Keywords

• atrophic posterior mandible
• inlay bone graft
• dynamic navigation
• piezosurgery
• safe osteotomies