The Sandwich Bone Augmentation Technique

Introduction: Horizontal ridge width reduction after tooth extraction is a common clinical scenario. As such, when implant-supported restorations are planned for tooth replacement, it is a challenge to regenerate adequate bone width to house the dental implant and ensure its long-term stability. Several horizontal ridge augmentation techniques, e.g. guided bone regeneration, ridge splitting, and block grafts, have been tested and proven to predictably augment bone width. Although these techniques are successful, treatment time is significantly increased and patients need to endure additional surgical procedures. Therefore, this case report aims at illustrating the ease and success of the sandwich bone augmentation technique when performed with dental implant placement. Case Presentation: A clinical case with a horizontally deficient ridge was selected. A buccal dehiscence was observed after placement of the dental implant in a prosthetically driven position. Autogenous bone graft harvested from the osteotomy site was placed on the exposed implant surface. Mineralized cancellous bone allograft was layered on, followed by a layer of mineralized cortical bone allograft. A collagen membrane was trimmed and used to contain the bone grafts as well as to exclude unwanted cells, such as epithelial cells and connective tissue fibroblasts. Tension-free primary closure was subsequently obtained. Six months later, mature regenerated bone was found on the buccal surface of the implant at surgical reentry. Conclusion: Simultaneous implant placement with the sandwich bone augmentation technique predictably regenerated bone on implant buccal dehiscence defects.