The Pre-Implant “Window-Osteotomy” Technique for the Atrophic Posterior Mandible

Preoperative clinical and radiologic situation.

Preoperative cone-beam computerized tomography slice in the second molar zone.

Figure 3. Surgical intervention: after elevating a full-thickness flap and exposing the buccal surface of the mandible, the window osteotomy was made using the OP1 Piezosurgery insert (c). Schematic drawings of this surgical phase in the (a) frontal plane and (b) a ¾ perspective. Figure 4. Surgical intervention: the window fragment was removed, exposing the trabecular portion of the mandibular body (c). Schematic drawings of this surgical phase in the (a) frontal plane and (b) a ¾ perspective. Figure 5. Surgical intervention: implant placement in the molar zone in a buccal position with respect to the nerve, as shown (a and b) graphically and (c) clinically.

Surgical intervention: the bone window fragment was replaced and fixed with a titanium miniplate and 2 miniscrews; all residual gaps were filled with bovine bone chips. (a and b) Graphic images and (c and d) clinical photos.

Postoperative cone-beam computer tomography slice in the second molar before implant placement.

(a) Lateral and (b) occlusal views of the definitive prosthesis at the end of follow-up (20 months after loading).

Figure 9. Panoramic radiograph taken 3 months after the surgical intervention, just before the prosthetic phase. Figure 10. Periapical x-ray taken at the end of follow-up.