Severe bone atrophies are considered a challenge in the rehabilitation process. In clinical situations involving excessive vertical bone deficiency in edentulous mandibles, there is a risk of fracture and frequently the need for an approach that involves highly complex procedures. In this context, simultaneous three-dimensional bone reconstruction associated with rigid fixation is a viable alternative to optimize longevity and avoid failures in these cases. This clinical case report presents a technique for reconstruction of severely atrophic mandibles in an elderly female patient to allow the implant-supported prosthesis protocol. The placement of immediate implants was possible by using an intraoral approach for fixation of a titanium plate followed by guided bone regeneration in association with recombinant human bone morphogenetic protein–2, deproteinized bovine bone mineral, and titanium mesh in a 1-stage surgical procedure. There are no reports in the literature of this approach for treating of severely atrophic mandibles. This association of techniques was shown to be predictable after 3 years of follow-up. Therefore, this protocol provides safe supported-implant prosthesis rehabilitation for patients with severely atrophic mandible.

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