article = {ORD-2019-1-103}
title = {An Osteoplastic Advancement Flap, “Sandwich” Osteotomy and Application of a Skin Regeneration Template Prior to Implant Placement}
journal = {Oral Rehabilitation and Dentistry}
year = {2019}
issn = {2733-2543}
doi = {http://dx.doi.org/10.31487/j.ORD.2019.01.03}
url = {https://www.sciencerepository.org/an-osteoplastic-advancement-flap-Sandwich-osteotomy-and-application-of-a-skin-regeneration-template-prior-to-implant-placement_ORD-2019-1-103 
author = {Andrea Beech,Jeremy Farrier,}
keywords = {Oral rehabilitation, sandwich osteotomy, skin regeneration system}
abstract ={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.}