Posterior Maxillary Segmental Osteotomy for Management of Insufficient Intermaxillary Vertical Space: An Updated Treatment Sequence.

Abstract

The effect of the time-to-treat for prosthetic rehabilitation of edentulous areas of the jaws can generate several intra-arch and inter-arch clinical changes over time, including alveolar or dentoalveolar block extrusion. To treat these conditions, posterior maxillary segmental osteotomy (PMSO) is a surgical option. This study reports a case of a patient who developed dentoalveolar block extrusion after postponing implant-supported prosthetic rehabilitation for 5 years. The PMSO was planned with the aid of model surgery and virtual planning. Under local anesthesia and oral sedation, the horizontal and vertical osteotomies were performed with a piezo saw and curved chisels. The block was fixed with a readapted titanium mesh, and an interim prosthesis was fixed on the dental implants. Although it's a technique with a long-time description, few published cases were found. In this sense, there is a need to improve the planning methods and surgical techniques with new technologies and materials that increasingly favor the predictability of the procedure and comfort to the patient.