"The dental cripple": a new approach to severe mandibular atrophy.

We have found this use of the composite graft of the severely atrophic mandible to offer a very predictable successful technique for the "severe dental cripple". It is only with the advent of the osseointegrated implants that this technique really can be fully utilized. The inferior border grafting certainly addresses the issue of pathologic fracture, but without the use of implants, it would not enhance the prosthetic environment intraorally. By combining these grafting and implant techniques, we feel that this is not only a predictable surgical technique, but it also offers the advantages of less resorption, cleaner surgical incisions, and less interruption of prosthesis use during the healing phases (Figs. 7 & 8). We are continuing to follow the initial group of patients who have undergone this therapy, and the lack of resorption to date has been extremely encouraging.