Sandwich osteotomy for the reconstruction of deficient alveolar bone.

Alveolar bone deficiency is a very common problem encountered by the practitioner when planning dental implants. The severity of the deficiency is variable. Many practitioners perform augmentation using the method they feel comfortable with and do not necessarily use the most appropriate method. This is a retrospective study on 21 patients between the ages of 25 and 63 years exhibiting moderate vertical alveolar bone deficiency and treated by the sandwich technique. Mean vertical bone gain was 7.5mm. Sixty-one dental implants were inserted showing a survival rate of 96.7% with a median of 3.1 years follow-up. Main advantages of the method include minimal relapse, single operation and preservation of the native cortical bone in the occlusal surface. We believe the surgeon should maintain the capability of using different augmentation techniques and utilize them appropriately for different severities of deficiency. We wish to establish a paradigm for using different augmentation methods We recommend using the sandwich technique in the moderate deficient cases as described in this work, using alveolar distraction osteogenesis for the severe cases as described in our previous work, where lack of soft tissue for proper closure is a major limitation, and using guided bone regeneration for minor deficiencies.