Clinical Case No. 26: AMSJI, Patient Specific Implants, Cutting Guide VOG and HOG

Abstract

In a 50-year-old male patient, after the extraction, there was advanced bone atrophy in height and thickness but in the second quadrant there was a residual knife blade shaped bone crest. The presence of a residual bone crest in the shape of a knife blade negatively affects the design and construction of the AMSJI implant because as the subperiosteal implant following the shape of the bone surface with a knife blade the structure of the implant would have many pointed areas. So to extend the indications of the AMSJI also to the IV Class of Cawood-Howell we have developed a surgical protocol that uses cutting guides to eliminate the areas of the bone crest with a knife blade. The first guide called VOG (Vertical Osteotomy Guide) guides the vertical osteotomy for vertical reduction, while the second guide called HOG (Horizontal Osteotomy Guide) is used for horizontal bone reshaping. The AMSJI implant is constructed considering the osteotomy lines and will be placed immediately after these in the same surgery. More details on the technique are published in the article: Rinaldi M, De Neef B, Loomans NA, Mommaerts MY. Guideline for the use of resection guides for subperiosteal maxillary implants in case of terminal dentition-A novel approach. Ann maxillofac Sure 2020; 10:467-71.