Journal of Maxillofacial and Oral Surgery

, Volume 16, Issue 4, pp 471–478 | Cite as

Effect of Alveolar Segmental Sandwich Osteotomy on Alveolar Height: A Preliminary Study

  • Karan S. Mehta
  • Kavitha Prasad
  • Vibha Shetty
  • Krishnappa Ranganath
  • R. M. Lalitha
  • Jayashree Dexith
  • Sejal K. Munoyath
  • Vineeth Kumar
Clinical Paper



Bone loss following extraction is maximum in horizontal dimension. Height is also reduced which is pronounced on the buccal aspect. Various surgical procedures are available to correct the bone volume viz. GBR, onlay bone grafting, alveolar distraction and sandwich osteotomy. Sandwich osteotomy has been found to increase the vertical alveolar bone height successfully.


The objective of the study was to assess the effect of alveolar segmental sandwich osteotomy on alveolar height and crestal width.

Materials and Methodology

A prospective study was undertaken from December 2012 to August 2014. Seven patients with 12 implant sites with a mean age of 36 years were recruited. All seven patients with 12 implant sites underwent alveolar segmental sandwich osteotomy and interpositional bone grafting. Alveolar bone height was assessed radiographically preoperatively, immediate post-op, and at 3 months post-op. Alveolar bone width was assessed radiographically preoperatively and at 3 months post-op. Statistical significance was inferred at p < 0.05.


The mean vertical augmentation at immediate post-op was 6.58 mm (p = 0.001). The vertical augmentation that was achieved 3 months post-op was a mean of 3.75 mm which was statistically significant (p = 0.004). The change in alveolar height from immediate post-op to 3 month post-op was a mean 1.69 mm. The mean change in alveolar crestal width at 3 months was a mean of −0.29 mm (p = 0.57).


Sandwich osteotomy can be used as an alternative technique to increase alveolar bone height prior to implant placement. Moderate alveolar deficiency can be predictably corrected by this technique.


Alveolar bone height Sandwich osteotomy Interpositional grafting Buccal onlay Sinus lift 



I would like to acknowledge my entire department (Department of Oral and Maxillofacial Surgery) for their continuous support and guidance during the period of study. Also, acknowledge the Department of Prosthodontics and Implantology for referring cases and the support for providing optimal patient care.


The study was partly supported by M. S. Ramaiah Dental College and Hospital.

Compliance with Ethical Standards

Conflict of interest

All authors have no conflict of interest in the study.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


  1. 1.
    Van der Weijden F, Dell’Acqua F, Slot DE (2009) Alveolar bone dimensional changes of post-extraction sockets in humans: a systematic review. J Clin Periodontol 36(12):1048–1058CrossRefPubMedGoogle Scholar
  2. 2.
    Jensen OT, Kuhlke L, Bedard J-F, White D (2006) Alveolar segmental sandwich osteotomy for anterior maxillary vertical augmentation prior to implant placement. J Oral Maxillofac Surg 64(2):290–296CrossRefPubMedGoogle Scholar
  3. 3.
    Choi B-H, Lee S-HR, Huh J-Y, Han S-G (2004) Use of the sandwich osteotomy plus an interpositional allograft for vertical augmentation of the alveolar ridge. J Cranio-Maxillofac Surg 32(1):51–54CrossRefGoogle Scholar
  4. 4.
    Jensen OT (2006) Alveolar segmental “sandwich” osteotomies for posterior edentulous mandibular sites for dental implants. J Oral Maxillofac Surg 64(3):471–475CrossRefPubMedGoogle Scholar
  5. 5.
    Laviv A, Jensen OT, Tarazi E, Casap N (2014) Alveolar sandwich osteotomy in resorbed alveolar ridge for dental implants: a 4-year prospective study. J Oral Maxillofac Surg 72(2):292–303CrossRefPubMedGoogle Scholar
  6. 6.
    Politi M, Robiony M (1999) Localized alveolar sandwich osteotomy for vertical augmentation of the anterior maxilla. J Oral Maxillofac Surg 57(11):1380–1382CrossRefPubMedGoogle Scholar
  7. 7.
    Hashemi HM, Javidi B (2010) Comparison between interpositional bone grafting and osteogenic alveolar distraction in alveolar bone reconstruction. J Oral Maxillofac Surg 68(8):1853–1858CrossRefPubMedGoogle Scholar
  8. 8.
    Felice P, Marchetti C, Piattelli A, Pellegrino G, Checchi V, Worthington H et al (2008) Vertical ridge augmentation of the atrophic posterior mandible with interpositional block grafts: bone from the iliac crest versus bovine anorganic bone. Eur J Oral Implantol 1(3):183–198PubMedGoogle Scholar
  9. 9.
    Jensen OT, Cottam J (2013) Posterior maxillary sandwich osteotomy combined with sinus grafting with bone morphogenetic protein-2 for alveolar reconstruction for dental implants: report of four cases. Int J Oral Maxillofac Implants 28(6):e415–e423CrossRefPubMedGoogle Scholar
  10. 10.
    Lopez-Cedrun JL (2011) Implant rehabilitation of the edentulous posterior atrophic mandible: the sandwich osteotomy revisited. Int J Oral Maxillofac Implants 26(1):195–202PubMedGoogle Scholar

Copyright information

© The Association of Oral and Maxillofacial Surgeons of India 2017

Authors and Affiliations

  • Karan S. Mehta
    • 1
  • Kavitha Prasad
    • 1
  • Vibha Shetty
    • 2
  • Krishnappa Ranganath
    • 1
  • R. M. Lalitha
    • 1
  • Jayashree Dexith
    • 1
  • Sejal K. Munoyath
    • 1
  • Vineeth Kumar
    • 1
  1. 1.Department of Oral and Maxillofacial Surgery, Faculty of Dental SciencesM. S. Ramaiah University of Applied SciencesBangaloreIndia
  2. 2.Departments of Prosthodontics and Implantology, Faculty of Dental SciencesM. S. Ramaiah University of Applied SciencesBangaloreIndia

Personalised recommendations