An Osteoplastic Advancement Flap, “Sandwich” Osteotomy and Application of a Skin Regeneration Template Prior to Implant Placement

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Author Info

Andrea Beech Jeremy Farrier

Corresponding Author

Andrea Beech
Department of Oral and Maxillofacial Surgery, Consultant Oral and Maxillofacial Surgery, Gloucestershire Royal Hospital, Gloucestershire Hospitals NHS Foundation Trust

A B S T R A C T

Introduction: Following oral cancer resection patients will have differing degrees of morbidity with regards to mastication, speech and aesthetics and this can be a difficult problem to manage. We present a case that describes an innovative technique involving implant placement and deepening of the labial sulcus in the atrophic mandible of a post-operative oral cancer patient to facilitate partial denture retention. Methods: a 70-year-old female patient presented with significant vertical and horizontal bone atrophy and a shallow, tethered labial sulcus in the anterior mandible, following cancer resection of the floor of mouth and alveolar ridge. She was unable to retain a partial denture. An initial procedure included an osteoplastic advancement flap and a horizontal “sandwich” osteotomy as a combined approach that improved the bone volume from a Cawood & Howell classification grade V to grade II. A sulcoplasty and insertion of Integra© skin regeneration system improved sulcus depth in a second procedure. Dental implants were successfully placed 4 months after bone augmentation to allow retention of a lower partial denture. Results: These staged procedures were carried out with excellent healing and no complications in the postoperative 6 months. Conclusion: This technique for gaining bony height and width, with improved sulcus depth in an atrophic mandible is a useful adjunct in the rehabilitation of post-operative oral cancer cases. Maintaining the periosteal attachment in the osteoplastic flap promotes excellent healing in patients who have received adjunctive radiotherapy treatment in this safe and effective osteotomy procedure.

Article Info

Article Type

Case Report

Publication history

Received: Thu 22, Aug 2019
Accepted: Thu 19, Sep 2019
Published: Fri 27, Sep 2019

Copyright

© 2023 Andrea Beech. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository.
DOI: 10.31487/j.ORD.2019.01.03