PMC5573495_01
Preoperative panoramic radiography of the patient.
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Faculty of Dentistry, Department of Oral and Maxillofacial Surgery for the  reconstruction of his atrophic maxilla in order to maintain prosthodontics rehabilitation with dental implant supported fixed prosthesis. Following clinical and  radiological examinations (Figure 1), it is decided to augment the atrophic maxilla by using autologous bone graft harvested from  the anterior iliac crest via CSEA.
Performing combined spinal epidural anesthesia through L3-L4 intervertebral level.
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CSEA was administered at the L3-L4 intervertebral disc level (Figure 2) and intravenous sedation was administered in addition  to local anesthesia.
Bicortical autonegonus bone graft harvesting procedure.
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A micro-saw and chisel were used to harvest a tricortical (corticocancellous) autogenous bone block from the anterior iliac crest  (Figure 3).
Clinical photograph of the surgical site before bone grafting.
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Fort 1 level incision by using needle tip electrocautery. Following flap elevation (Figure 4) the  bone graft was modified and fixed to the recipient site by using titanium mini-screws to avoid micromovements of the bone graft during healing period  (Figure 5).
Bone blocks harvested from the anterior iliac crest were positioned along the contour of the maxillary arch.
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Fort 1 level incision by using needle tip electrocautery. Following flap elevation (Figure 4) the  bone graft was modified and fixed to the recipient site by using titanium mini-screws to avoid micromovements of the bone graft during healing period  (Figure 5).
Postoperative panoramic radiography after anterior iliac crest bone grafting and bilateral sinus lifting procedure.
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The positions of the autogenous bone grafts and augmented sinuses were controlled by panoramic radiography (Figure 6).
Postoperative panoramic radiography after dental implant operation.
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AL, USA) dental implants were placed. After the osseointegration period of dental implants, the patient was referred to the  prosthodontics clinic for the fabrication of implant supported fixed prosthesis (Figure 7).