This paper reports on a segmental osteotomy procedure with an interpositional graft in the posterior maxillary region with 9 years of follow-up.

The techniques used to overcome a lack of alveolar bone height rely on the placement supplemented by various vertical guided bone regeneration (GBR) procedures [4, 5] and the use of alveolar distraction osteogenesis [6], titanium mesh [7], or onlay bone graft [8]. Gains in ridge height of between 3.6 and 9.2 mm depending on the materials used have been reported, and these were associated with 5-year implant survival rates of 97 to 100%, depending on the method employed [3]. On the other hand, it has also been reported the number of complications (e.g., flap dehiscence, barrier exposure) and failures of the augmentation procedure (e.g. infection, graft bone necrosis) [3,4,5,6,7,8]. Additionally, the biomaterials used as substitutes for the bone require a longer healing time than autologous bone because the substitutes in general are not osteoinductive [3].

Although a certain amount of slow appositional bone growth from the bony walls into the defect is observed, this growth depends on the growth of new blood vessels between each particle. In the alveolar crest, it spontaneously stops at a distance of few millimeters above the defect bone wall. The more distant particles instead heal within fibrous tissue to form a scar. This is expected to have a negative effect on the long-term survival of the restoration [3].

The use of short implants is another possibility when alveolar bone height is inadequate for regular implants. The use of such implants can reduce treatment time, cost, and postoperative morbidity compared to bone augmentation procedures. The first EAO consensus conference (2006) had defined short implants as a device with a design intrabony length of 8 mm or less [21] and had demonstrated high success rates and predictable clinical outcomes for placement of short implants [12,13,14], but there were still controversies regarding the long-term consequences of peri-implant bone loss around short implants and its impact on the long-term implant success rate at that time.