*The Use of Cortical Bone Wedges from the Mandibular Ramus "Wedge Technique"… DOI: http://dx.doi.org/10.5772/intechopen.100099*

#### **Table 1.**

*Patients demographics, augmented sites, and the donor sites.*

with a bone deficit that needs vertical, horizontal or combined vertical and horizontal bone augmentation. The exclusion criteria were the severe atrophy of the mandibular retromolar area (the donor site); and patients with less than 3 mm bone over the inferior alveolar nerve at the posterior mandibular ridge.

Patients with informed consent underwent bone augmentation with the WT at least at one site in different arch regions. The retromolar/ramus area was the donor site of the bone cortical wedges of this technique. Post-operative instructions included a soft diet for six weeks, antibiotics for ten days, and meticulous oral hygiene. In addition, the use of removable appliances was not allowed.

Follow-up examinations were performed every 2 weeks. Four months after the surgery, the recipient site was evaluated clinically (to assess the contour and the volume of the augmented ridge), and radiographically (by computed tomography) to examine the bone gain and the new available bone for dental implant placement. Reentry was performed after 4 to 5 months to evaluate the new bone volume, to obtain biopsy specimens and to insert implants. The prosthetic rehabilitation was allowed 4 months after the placement of the dental implants. Follow-up of the bone augmentations and implants that were inserted at these sites, included periodic clinical evaluation and periapical radiographs. All the surgical procedures and postoperative evaluations were performed by the author.

### **2.1 Technique**

Illustration case; 55 years old female was referred to the pre-prosthetic unit at our department for bone augmentation of her posterior mandible bilaterally and placement of dental implants. On examination; a healthy patient presented with bilateral posterior mandibular edentulism (Kennedy class-1).

Both of the residual ridges had more than 20 degrees of bone angulation toward the lingual side (**Figure 1a**). CBCT showed moderate to severe atrophy of both posterior mandibular ridges (**Figure 1b**–**d**). Short implants were not an option due to the severe lingual angulation, and inadequate bone width of the residual ridges. Guided implant placement was not a treatment option as well due to the central location of the inferior alveolar nerve. This case necessitated bone augmentation and was treated with the WT.

#### **Figure 1.**

*Bilateral edentulous posterior mandibular ridges. (a) Clinical view. (b–d) Computed tomography shows inadequate bone in height, width, and angulation.*

*The Use of Cortical Bone Wedges from the Mandibular Ramus "Wedge Technique"… DOI: http://dx.doi.org/10.5772/intechopen.100099*
