Current Therapeutic Options for Implant-Supported Rehabilitation of Severely Atrophic Mandibles

Abstract

The implant-supported rehabilitation of atrophic mandibles (AM) with severe bone resorption is challenging for both surgical and prosthetic procedures due to the high risk of mandible fracture during implant surgery and postoperatively due to the masticatory load. The aim of case presentations was to demonstrate treatment alternatives for patients with AM who required oral rehabilitation with osseointegrated implants (OIs) according to the residual mandibular bone volume. When bone is 9 mm in height, the ideal treatment is the use of narrow, short OIs. When the bone height is 5 to < 9 mm, mandibular reinforcement with reconstruction plates using the intraoral approach and simultaneous placement of osseointegrated implants are proposed. In cases where bone height is < 5 mm, the choice of treatment is mandibular reconstructive surgery with an autogenous bone graft and biomaterials. The fundamental principles of this protocol are to reduce the morbidity and complications associated with the surgical procedure, which would reduce both the time and cost of full dental rehabilitation. The choice of the technique for mandibular reconstruction should be indicated according to the magnitude of the atrophy.