Validity of Mandibular Segmental Osteoperiosteal Flap With Simultaneous Dental Implant and Alloplast Interpositional Material Placement: A Retrospective Study

Background: Vertical bone augmentation in the atrophic posterior mandible remains challenging in implant dentistry. The mandibular segmental osteoperiosteal flap technique with simultaneous implant placement offers an alternative to staged procedures, potentially reducing treatment time while maintaining predictable outcomes.Objective: To evaluate clinical validity and radiographic outcomes of mandibular segmental osteoperiosteal flap with simultaneous dental implant placement and interpositional alloplastic material augmentation.Methods: This retrospective study analyzed 20 patients (mean age 35.90 ± 6.90 years; 75% female) who underwent segmental osteoperiosteal flap surgery with simultaneous implant placement between 2018-2023. Patients had posterior mandibular bone height of 5-8 mm with minimum 6-month follow-up. Procedures utilized tricalcium phosphate interpositional grafting and 3.75×10 mm implants. Cone-beam computed tomography assessments evaluated vertical bone height gain, crestal bone loss, and bone density changes at 6 months postoperatively. Results: All implants achieved 100% survival rate. Mean vertical bone gain was 4.10 ± 0.51 mm, increasing from preoperative 6.01 ± 0.95 mm to 10.11 ± 1.08 mm postoperatively (p < 0.001). Mean crestal bone loss measured 0.98 ± 0.88 mm. Complications included soft tissue dehiscence in 6 cases (30%) and delayed bleeding in 2 cases (10%), with no implant failures. Conclusions: Mandibular segmental osteoperiosteal flap with simultaneous implant placement demonstrates predictable outcomes for vertical bone augmentation, achieving significant bone height gain while reducing treatment duration compared to staged approaches.