In situ flip osteotomy bone block: an alternative bone graft harvesting site proposal for anterior maxillary bone defects. A case report at 3-year follow-up

BACKGROUND: This article describes a novel approach for the reconstruction of vertical and horizontal bone defects in the anterior maxilla that involves the use of an autogenous block graft harvested and rotated from the same surgical site. A case with a 3-year follow-up, featuring a vertical-horizontal bone deficiency, is presented as an example. CASE PRESENTATION: A bone deficiency is presented at the 2.2 position. Through the use of a piezoelectric instrument, a bone block apical to the defect is harvested. The osteotomy produces a preoperatively planned volume and shape of the bone block, which is then perfected, flipped upside down and fixed using osteosynthesis screws, with the thickest portion in the crestal area. The reconstruction provided sufficient volume for the implant rehabilitation. After 3.5 years, bone remodelling appears contained; the horizontal volume is maintained. CONCLUSIONS: When residual anatomy appears eligible for this approach, this technique may represent an alternative to ectopic bone harvesting, thus reducing the patient's discomfort and surgical invasiveness.