Full-Arch Vertical Reconstruction of an Extremely Atrophic Mandible With “Box Technique.” A Novel Surgical Procedure

Abstract

To describe a new augmentation procedure named "box technique" for bone reconstruction in a severely atrophic jaw with mandibular and mental nerve dehiscence. The first surgical box technique procedure was performed to augment the atrophic posterior area. Simultaneously, 2 implants were inserted into the interforaminal zone to stabilize the denture. After 6 months, 2 implants were positioned in the regenerated bone, and a second box technique procedure was performed to reconstruct the ridge in the area of fixture exposition. Six months after the second surgery, the patient was rehabilitated with a removable prosthesis retained on 4 implants. The clinical and histologic analyses highlighted outstanding healing resulting from this vertical and horizontal allografting and included complete resorption of poly D,L-lactide meshes and substitution of the mineralized human bone allograft with an excellent quality new bone formation. Results confirm the effectiveness of the technique, which needs a further case series study endorsing its reliability.