Horse-shoe sandwich osteotomy of the edentulous maxilla as a preprosthetic procedure.

A preprosthetic procedure for treatment of severe atrophy of the maxilla is reported. By means of the horse-shoe sandwich osteotomy of the edentulous maxilla with interposition of iliac crest or ribs in combination with a modified submucous vestibuloplasty there is the possibility of increasing the vestibular and palatal height and improving the mucosal contour in one surgical session. The method, which is described in details, avoids the disadvantages of the earlier operation methods of direct osseous augmentation and the Le Fort-I-osteotomy of the edentulous maxilla. The satisfactory results of 15 operated cases in the observation period of 3 to 15 months are reported. There is only little bone resorption. The horse-shoe sandwich osteotomy might therefore be the method of choice in cases of extreme atrophy of the maxilla.