title: Calvarial onlay graft and submental incision in treatment of atrophic edentulous mandibles: an approach to reduce postoperative complications.
abstract: OBJECTIVE
  The aim of this study was to test our approach based on the use of calvarial graft and extraoral approach, in treatment of severe mandibular atrophies with implant surgery and prosthetic rehabilitation.
  
  
  METHODS
  We selected 6 patients, 4 females and 2 males, completely edentulous with a severe mandibular atrophy (class VI Cawood and Howell classification). Mean age of patients was 63 years, ranging from 60 to 67 years. Mandibles were reconstructed with a submental incision with calvarial bone graft harvested from parietal area. After a mean of 4.2 months, each patient received 4 implants, and after a mean of 4.67 months, implants were loaded.
  
  
  RESULTS
  No complications occurred in donor site or on the mandible, and all patients recovered well. No extraoral scar occurred. A total of 25 implants were inserted, and, with exception of an early failure and successive replacement, all implants were osseointegrated at successive visits. After 1-year follow-up, our analysis showed 100% implants survival and correct fit and success of prosthetic rehabilitation.
  
  
  CONCLUSIONS
  Results of this study showed an uneventful recovery for all patients with our approach and reduced healing time of bone graft. So extraoral approach with submental incision and calvarial graft is a reliable method in reconstruction of atrophic mandibles, and staged implant surgery is suggested.
authors.affiliation: From the *Department of Maxillofacial Surgery, "Sapienza" University of Rome, Rome; and †Department of Maxillofacial Surgery and ‡Tuscan School of Dental Medicine, University of Siena, Siena, Italy.
authors.forename: Pierpaolo
authors.initials: P
authors.lastname: Sassano
authors.forename: Paolo
authors.initials: P
authors.lastname: Gennaro
authors.forename: Glauco
authors.initials: G
authors.lastname: Chisci
authors.forename: Guido
authors.initials: G
authors.lastname: Gabriele
authors.forename: Ikenna Valentine
authors.initials: IV
authors.lastname: Aboh
authors.forename: Valeria
authors.initials: V
authors.lastname: Mitro
authors.forename: Paolo
authors.initials: P
authors.lastname: di Curzio
mesh_terms: D000368:Aged; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D001284:Atrophy; D016025:Bone Transplantation / Q000379:methods*; D002680:Chin / Q000601:surgery*; D003758:Dental Implantation, Endosseous / Q000379:methods*; D019094:Dental Prosthesis, Implant-Supported; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007575:Jaw, Edentulous / Q000601:surgery*; D008297:Male; D008334:Mandible / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*