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Full-Arch Vertical Reconstruction of an Extremely Atrophic Mandible With “Box Technique.” A Novel Surgical Procedure: A Clinical and Histologic Case Report

Menoni, Andrea DDS*; Bernardello, Fabio MD, DDS; Spinato, Sergio DDS; Zaffe, Davide MBioSc§

doi: 10.1097/ID.0b013e318278fa1c
Clinical Science and Techniques

Purpose: To describe a new augmentation procedure named “box technique” for bone reconstruction in a severely atrophic jaw with mandibular and mental nerve dehiscence.

Material and Methods: The first surgical box technique procedure was performed to augment the atrophic posterior area. Simultaneously, 2 implants were inserted into the interforaminal zone to stabilize the denture. After 6 months, 2 implants were positioned in the regenerated bone, and a second box technique procedure was performed to reconstruct the ridge in the area of fixture exposition. Six months after the second surgery, the patient was rehabilitated with a removable prosthesis retained on 4 implants.

Results: The clinical and histologic analyses highlighted outstanding healing resulting from this vertical and horizontal allografting and included complete resorption of poly D,L-lactide meshes and substitution of the mineralized human bone allograft with an excellent quality new bone formation.

Conclusions: Results confirm the effectiveness of the technique, which needs a further case series study endorsing its reliability.

*Private Practice, Parma, Italy.

Private Practice, Legnago, Italy.

Professor, Unit of Periodontology and Implantology, School of Dentistry, University of Bologna, Bologna, Italy.

§Professor, Human Morphology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.

Reprint requests and correspondence to: Davide Zaffe, MBioSc, Dip. di Scienze Biomediche, Metaboliche e Neuroscienze, Sezione di Morfologia umana, Università di Modena e Reggio Emilia, Via del pozzo 71, Policlinico, 41124 Modena, Italy, Phone: +39-059-422-4804, Fax: +39-059-422-4861, E-mail:

© 2013 Lippincott Williams & Wilkins, Inc.