Sandwich Bone Graft Covered With Buccal Fat Pad in Severely Atrophied Edentulous Maxilla: A Clinical Report
A 48-year-old woman with a severely atrophied maxilla was treated with open sinus augmentation surgery along with Le Fort I osteotomy with a pedicled buccal fat pad graft to position the maxilla in a right occlusal plane with respect to the mandible and to construct adequate bone volume allowing proper implant placement. Six dental implants were inserted in the maxilla, and a fixed metal-resin screw-retained prosthesis was fabricated for the maxilla and mandible.Abstract

Preoperative frontal (left) and lateral (right) view of the patient.

Figure 2 . Intraoperative view showing rigid fixation of the osteotomized maxilla after downward and forward repositioning. Figure 3. Inlay iliac bone graft and stabilizing titanium mesh. Figure 4. Buccal fat pad herniated into the mouth, expanded over the new reconstructed maxilla, and sutured to L mini plates. Figure 5. Postoperative panoramic X ray showing reconstructed maxilla and implants in the mandible. Figure 6. Intraoperative view of implant placement. Figure 7. Postoperative panoramic X ray showing all implants placed in the maxilla and mandible.

Frontal (left) and lateral (right) view of the patient with upper and lower prostheses in mouth.
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