[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-460591-105":59,"doc-detail-460591-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","in-situ-flip-osteotomy-bone-block-an-alternative-bone-graft-harvesting-site-proposal-for-anterior-maxillary-bone-defects","In situ flip osteotomy bone block - an alternative bone graft harvesting site proposal for anterior maxillary bone defects","","This case report presents a novel autogenous strategy for reconstructing vertical and horizontal bone defects in the anterior maxilla. An apical bone block is harvested from the same surgical site using piezoelectric instrumentation, shaped to a preoperative plan, flipped upside down, and fixed with osteosynthesis screws, with the thickest portion positioned at the crestal area. At 3.5 years, bone remodeling remains contained while horizontal volume is preserved, supporting implant rehabilitation and reduced patient discomfort.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/in-situ-flip-osteotomy-bone-block-an-alternative-bone-graft-harvesting-site-proposal-for-anterior-maxillary-bone-defects/460591/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/in-situ-flip-osteotomy-bone-block-an-alternative-bone-graft-harvesting-site-proposal-for-anterior-maxillary-bone-defects/460591.png","ImageObject",300,407,{"name":92,"@type":93},"Eliana","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":52},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What is the key concept of the in situ flip osteotomy bone block technique?","Question",{"text":112,"@type":113},"A bone block is harvested from the same surgical site, rotated (“flipped” upside down), and fixed so it provides the needed volume and shape for reconstructing anterior maxillary bone defects.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How is the bone block harvested and prepared in this case?",{"text":117,"@type":113},"A piezoelectric instrument is used to harvest an apical bone block to the defect. The osteotomy is designed to produce a planned volume and shape, then the block is perfected and flipped.",{"name":119,"@type":110,"acceptedAnswer":120},"What outcomes were observed during follow-up?",{"text":121,"@type":113},"After 3.5 years, bone remodeling appears contained and the horizontal volume is maintained, providing sufficient volume for implant rehabilitation.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},460591,1790790139,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":52,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":52,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},4398048949847,"https://ap-avatar.wpscdn.com/avatar/400002536579ef2da7f?_k=1778318612642679267","Oral and Maxillofacial Surgery (2026) 30:14 [https://doi.org/10.1007/s10006-025-01498-1](https://doi.org/10.1007/s10006-025-01498-1)  \nCASE REPORT  \nIn 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  \nDavide Farronato1 · Leonardo Romano2 · Luca Poncia2 · Lorenzo Azzi1 · Luca Levrini3 · Marco Farronato4  \nReceived: 5 October 2025 / Accepted: 9 December 2025 © The Author(s) 2026  \nAbstract  \nBackground 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.  \nCase 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.  \nConclusions 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.  \nKeywords Dentistry · Implantology · Vertical bone regeneration · Onlay graft · Piezoelectric surgery.  \n􀀍 Leonardo Romano[lromano2@studenti.uninsubria.it](lromano2@studenti.uninsubria.it)  \nDavide Farronato  \n[davide@farronato.it](davide@farronato.it)  \nLuca Poncia  \n[lponcia@studenti.uniunsubria.it](lponcia@studenti.uniunsubria.it)  \nLorenzo Azzi  \n[l.azzi@uninsubria.it](l.azzi@uninsubria.it)  \nLuca Levrini  \n[luca.levrini@uninsubria.it](luca.levrini@uninsubria.it)  \nMarco Farronato  \n[marcofarronato@msn.com](marcofarronato@msn.com)  \n1 Department of Medicine and Technological Innovation, School of Dentistry, University of Insubria, Varese, Lombardy 21100, Italy  \n2 Department of Medicine and Surgery, School of Dentistry, University of Insubria, Varese, Lombardy 21100, Italy  \n3 Department of Human Sciences, Innovation and Territory, School of Dentistry, Postgraduate of Orthodontics, University of Insubria, Varese, Lombardy 21100, Italy  \n4 Ospedale Maggiore Policlinico, Fondazione IRCCS Cà Granda, Milan, Lombardy 20122, Italy  \nIntroduction  \nAs described by Cawood and Howell in 1988 [1], the alveolar process undergoes morphological changes after tooth loss. Wolff’s law explains these modifications, affirming that bone mass and structure adapt to the mechanical loads to which they are subjected [2] . Since the load needed to maintain bone volume can not be reached after tooth loss, a decrease in the latter will occur [3] .  \nIn case of insufficient bone quantity, bone augmentation procedures may be necessary to obtain a correct threedimensional implant position for successful aesthetic and functional outcomes and long-term survival of implantprosthetic rehabilitation [4, 5] . Several treatment options for vertical bone defects are described in the literature. These include guided bone regeneration (GBR) that can be performed using titanium-reinforced non-resorbable e-PTFE membranes [6, 7], resorbable collagen membranes without any fixation [8], resorbable collagen membranes fixated with tenting screws [9], titanium mesh covered by resorbable collagen membranes [10], and resorbable collagen membranes fixed with osteosynthesis plates [11] . Other  \n1 3  \noptions are bone block grafts and alveolar distraction osteogenesis [12] .  \nThree main strategies for bone block grafting are presented in the literature: the onlay, the inlay and the shell techn","cbCaii4wyb32orFk","https://ap.wps.com/l/cbCaii4wyb32orFk","pdf",1577225,"English","# Case report\n## Abstract\n# Introduction\n## Bone defects after tooth loss and need for augmentation\n## Treatment options for vertical bone defects\n## Block grafting strategies: onlay, inlay/sandwich, and split bone block\n## Literature contributions on in situ block harvesting\n## Case details of prior in situ approaches","[{\"question\":\"What is the key concept of the in situ flip osteotomy bone block technique?\",\"answer\":\"A bone block is harvested from the same surgical site, rotated (“flipped” upside down), and fixed so it provides the needed volume and shape for reconstructing anterior maxillary bone defects.\"},{\"question\":\"How is the bone block harvested and prepared in this case?\",\"answer\":\"A piezoelectric instrument is used to harvest an apical bone block to the defect. The osteotomy is designed to produce a planned volume and shape, then the block is perfected and flipped.\"},{\"question\":\"What outcomes were observed during follow-up?\",\"answer\":\"After 3.5 years, bone remodeling appears contained and the horizontal volume is maintained, providing sufficient volume for implant rehabilitation.\"}]","In situ flip osteotomy bone block - an alternative bone graft harvesting site proposal for anterior maxillary bone defects | PDF",1790758841,25]