Reconstruction of a Severe Mandibular Atrophic Ridge with Autogenous Iliac and Rib Bone Grafts

Prosthetic rehabilitation requires sufficient hard and soft tissues. In this article, a case of severe mandibular atrophic ridge is presented, which has been treated with autogenous iliac and rib bone grafts and simultaneous nerve transposition with an extraoral approach.

The patient was a 56-year old female with severe mandibuar atrophic ridge. The prosthetic rehabilitation for this patient was performed in four stages: 1) reconstruction of mandibular atrophic ridge using autogenous iliac and rib bone graft with simultaneous inferior nerve transposition through an extraoral approach, 2) insertion of four implant fixtures in reconstructed mandibular ridge after six months, 3) buccal and lingual vestibuloplsty and free gingival graft and loading of healing abutments, three months later, and 4) prosthetic rehabilitation after two months. Following stage four, a mandibular hybrid prosthesis on four implants with a maxillary removable complete denture were delivered to the patient.

 Following four stages of surgical and prosthetic procedures, rehabilitation of a severe mandibular atrophic ridge was done with autogenous iliac and rib bone grafts, simultaneous inferior alveolar nerve transposition and a mandibular hybrid prosthesis on four implants. Further follow up of the patient will reveal the outcomes of this procedure.

  This procedure can be suggested in the case of severe mandibular atrophic ridges which need inferior border augmentation and superior border vertical and horizontal augmentation at the same time.