THE MANAGEMENT OF THE SEVERELY ATROPHIC MANDIBLE

Severe atrophy of the partially or totally edentulous mandible represent a challenge for dental rehabilitation by means of implant-supported prostheses, due to lack of available bone, superficialization of alveolar nerve, and unfavorable intermaxillary relationships. Several surgical options have been proposed over the years in order to overconme these problems, such as guided bone regeneration, autogenous bone grafts, revascularized free flaps, and distraction osteogenesis. However, each technique may present peculiar indications, advantages and disadvantages, which may lead to controversial viewpoints. Yhe aim of this lecture is to present rational surgical protocols underlining prosand cons of each technique reporting long-term results and reliability of different techniques and long-term survival and success rates of implants placed in the reconstructed areas.