Implants in the severely resorbed mandibles: whether or not to augment What is the clinician’s preferenceReport as inadecuate

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Oral and Maxillofacial Surgery

, Volume 15, Issue 4, pp 225–231

First Online: 19 August 2011Received: 22 November 2010Accepted: 03 August 2011


IntroductionThe aim of this study is to inventory in the Netherlands which therapy is the clinician’s first choice when restoring the edentulous mandible.

Material and methodsA questionnaire was sent to all Dutch Oral and Maxillofacial surgeons. As part of this, the surgeons were invited to treat five virtual edentulous patients, differing only in mandibular residual height.

ResultsIn cases of a sufficient residual height of 15 mm, all surgeons were in favour to insert solely two implants to anchor an overdenture. In case of a residual height of 12 mm, 10% of the surgeons choose for an augmentation procedure. If a patient was presented with a mandibular height of 10 mm, already 40% of the OMF surgeons executed an augmentation procedure. Most 80% surgeons prefer the anterior iliac crest as donor site. The choice of ‘whether or not to augment’ was not influenced by the surgeon’s age; however, the hospital, where he was trained, did. Surgeons trained in Groningen were more in favour of installing short implants in mandibles with reduced vertical height.

DiscussionAs the option overdenture supported on two interforaminal implants is reimbursed by the Dutch health assurance, this treatment modality is very popular in the Netherlands. From a point of costs and to minimize bypass comorbidity, surgeons should be more reluctant in executing augmentation procedures to restore the resorbed edentulous mandible as it is dated in literature that also in mandibles with a residual height of 10 mm or less, solely placing implants, thus without an augmentation procedure in advance, is a reliable treatment option.

KeywordsAtrophic mandible Pre-prosthetic surgery Bone augmentation Endosseous implants Electronic supplementary materialThe online version of this article doi:10.1007-s10006-011-0285-6 contains supplementary material, which is available to authorized users.

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Author: Frits B. T. Perdijk - Gert J. Meijer - Ewald M. Bronkhorst - Ron Koole


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