Alveolar Sandwich Osteotomy Technique for Vertical Ridge Augmentation

Alveolar sandwich osteotomy is a technique in which the graft is believed to undergo a rapid incorporation because it is placed between two pieces of pedicled bone with internal cancellous bone and good vascular supply.

The purpose of this prospective study was to assess the outcome of sandwich osteotomy technique for vertical ridge augmentation in terms of bone gain, segment vitality, and complications.

Twenty partially edentulous patients that required implant placement with vertical bone augmentation were selected. Vertical ridge augmentation was performed using a piezo-surgery device in 20 sites (17 mandible and three maxilla). The xenograft block was sandwiched followed by GBR membrane placement and closure. The height gained was measured pre-operatively, post-operatively, and six months post-operatively using CBCT/OPG.

The mean vertical bone height gain was 4.46 mm after augmentation, and it remained stable after six months at mean height of 4.08 mm without significant bone resorption (mean 0.5 mm). In two cases, wound dehiscence was observed which healed in one week without further complication. Bone segment was found to be vital after six months with osteocytes and bone marrow spaces.

The sandwich osteotomy technique using xenograft is a viable and predictable technique for vertical bone height gain.