DL Oral SurgeryBone reconstruction · Khoury philosophy

February 9, 2014

Implants on 3D Mandibular Reconstruction: Clinical Case

2014year
15photographs
—sections
Implants on 3D Mandibular Reconstruction: Clinical Case
Situación a los 4 meses
Situation after 4 months

Dear Colleagues,

A couple of months ago, we shared a case involving mandibular reconstruction using tunnel access. You can view the full surgical sequence here:
🔗 Gaining height in the posterior mandible

Five months after the bone graft, we proceeded with the next phase: placing implants on 3D mandibular reconstruction using a modified Kazanjian Vestibuloplasty approach. This technique allowed us to manage both soft tissue and implant placement in a single session.

Modified Vestibuloplasty for Mandibular Implants

We started with a vestibular incision to separate an epithelial plate. The muscle was carefully released, preserving the periosteum. This step gave us access to remove osteosynthesis screws and place 10 mm implants in the regenerated bone.

As confirmed in the tomographic images, initial height was just 2.8 mm. Thanks to vertical augmentation, we reached over 10 mm—sufficient for placing standard-length implants with stability.

We closed the vestibuloplasty by suturing the periosteal and epithelial plates to the periosteum, ensuring tissue control and healing.

Reflections on Placing Implants on 3D Mandibular Reconstruction

Performing implants on 3D mandibular reconstruction highlights the importance of pre-planned bone architecture. Proper vestibular access facilitates both surgical and aesthetic outcomes.

📎 See more clinical cases of bone grafting

Below you’ll find photos from the surgical procedure.

gaining height in posterior mandible
Defect visible, tongue and floor of the mouth in black and white and
Defect on CT
Defect on CT
Measuring defect
Measuring defect
gaining height in posterior mandible
Tunnelisation
gaining height in posterior mandible
Crestal graft
gaining height in posterior mandible
Autologous filling in
Situation after 4 months
Situation after 4 months
Control x-ray
Control x-ray
kazanjian vestibuloplasty
Vestibuloplasty access
Appearance of graft
Appearance of graft
10mm long implants in place
10mm long implants in place
Post-graft x-ray
Post-graft x-ray
Situation 3 months after placement of implants
Situation 3 months after placement of implants

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