Atrophic Posterior Mandible Reconstruction Using 3D Tunnel Technique

This case focuses on a complex atrophic posterior mandible reconstruction in a young adult patient. A 32-year-old male, with no relevant medical history, came to us after losing implant 46 due to a peri-implant infection.

Assessing Severe Bone Loss in the Posterior Mandible

Upon radiographic evaluation, we observed a pronounced vertical defect with only 2.4 mm of residual bone above the inferior alveolar nerve. This made it impossible to place even short implants with predictable outcomes.

We ruled out nerve lateralization because of previous episodes of hypaesthesia and compromised soft tissue. Therefore, we opted for vertical bone augmentation using the 3D tunnel technique.

Atrophic Posterior Mandible Reconstruction with 3D Grafting

To perform the atrophic posterior mandible reconstruction, we used a tunnelised approach to preserve the periosteum and its blood supply. We harvested an autologous bone block from the ipsilateral mandibular ramus.

The graft was shaped three-dimensionally and inserted without lifting a full-thickness flap. This technique reduces trauma, ensures vascularisation, and supports volume stability during healing.

Long-Term Results and Implant Placement

After one year, the augmented bone maintained its height and density. This allowed us to place implants safely and restore function in the posterior maxilla.

You can view the full implant phase here:

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