Severe Mandibular Atrophy Treated With a Subperiosteal Implant and Simultaneous Graft With rhBMP-2 and Mineralized Allograft: A Case Report
A 71-year-old patient was successfully rehabilitated by means of a 3D model-derived, hydroxyapatite-coated titanium subperiosteal mandibular implant. The implant was specifically designed to allow bone augmentation. The deficient bone was simultaneously grafted with mineralized bone allograft and recombinant bone morphogenetic protein −2 (rhBMP–2). The 32-month postoperative cone beam computerized tomography follow-up showed vertical bone augmentation beneath the implant frame.

(a) pre-operative CBCT right mandible. (b) pre-operative CBCT left mandible. Figure 2. Stereolithographic model of the patient's mandible and complete denture. Figure 3. Build-up of the mandibular anatomy to the desired alveolar dimension. Figure 4. Refractory stone model with the subperiosteal implant created in wax.

Figure 5. (a) Immediate postoperative CBCT follow-up right mandible. (b) Immediate postoperative CBCT follow-up left mandible. Figure 6. (a) 32-month CBCT follow-up right mandible. (b) 32-month CBCT follow-up left mandible.

Figure 7. 32-month follow-up patient's occlusal view. Figure 8. 32-month follow-up patient's smile.
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