The Interpositional Bone Block Technique

Life surgery seminar

The interpositional Bone Block Technique in the treatment of the atrophic posterior mandible

ABSTRACT
The rehabilitation of the partially edentulous posterior mandible is acommon clinical problem. The ideal solution would be an implant-supported fixed prosthesis. The main obstacle associatedwith this treatment option is the lack of sufficient bone height. As a consequence the ideal approach would be to augment bone vertically in a predictable and successful way. A possible approachis to use an interpositional bone graft. Horizontal osteotomy with the
interposition of bone in the form of a “sandwich” involves raising a coronal osteotomised segment of the mandible, which is still attached to the lingual periosteum, and interpositioning of a bone block graft. This technique offers the advantage of guaranteeing a greater vascular supply, coming from the lingual periosteum andfrom the residual bone, to the inlay graft; it also allows optimum use of the native basal bone, which should be less prone to resorption.
Frequently, the interpositional technique was associated with autologous bone harvesting which involves discomfort and post-surgical morbidity, however data suggest that heterologous bone blocks in the inlay technique are similar in results to autogenous bone blocks. The use of heterologous bone blocks
allows avoiding grafting from the iliac crest related with significant patient discomfort, postoperative morbidity and complications.
Hence, the interpositional technique in the posterior atrophic mandible rehabilitation can be considered a reliable solution that allows an increase in bone height sufficient for implant placement quite stable over time avoiding autogenous bone harvesting.

WHAT WILL YOU LEARN?
The first day of the course consists in a lecture on the interpositional bone block technique focusing on indications, surgical technique (incision, osteotomy lines, vertical bone segment raising, bone block positioning, fixation and sutures). Advantages, disadvantages and comparisons with other augmentation techniques will be taken into consideration together with the current scientific evidence coming from the literature. Surgical videos will be shown to better explain the technique.
During the second day of the course, participants will have the chance to assist to an interactive step-by-step live surgery on patient and to participate to a hands-on session on porcine mandible model to become familiar with the technique.

Friday 15th November 2019

09,00-11,00 Interpositional bone block technique: Part 1
11,00-13,00 Interpositional bone block technique: Part 2
13,00-13,30 Discussion
13,30-14,00 Lunch
15,00-17,00 Live surgery
17,00-18,30 Discussion

Saturday 16th November 2019

09,00-13,00 Hands-on workshop
13,00-13,30 Discussion