Background: Surgical reconstruction of vertically atrophied ridges can be performed with onlay bone grafts or guided bone regeneration with membranes or meshes. Another option is by elevating a segmental osteotomy that is bone grafted interpositionally, the so-called sandwich osteotomy.

Objectives: To report a retrospective study of 80 consecutive posterior mandibular segments treated with the sandwich bone graft, and the outcome of the inserted implants.

Methods: 80 sites of moderate–severe posterior edentulous atrophy in 61 patients were grafted. The surgical technique includes a sandwich osteotomy above the mental nerve and the interposition of a block bone graft. Implant insertion was carried out under local anaesthesia 5–6 months after bone grafting procedure. We evaluated the survival and success rates of implants inserted.

Results: Eighty interpositional grafted segments in 61 patients were evaluated. Seventy-four segments received implants, in which 154 implants were inserted. Most patients received 10–12 mm implants. Only 18 implants had a length less than 10 mm. No implant lost was observed in the follow-up.

Conclusion: The sandwich osteotomy technique is useful to increase bone height above the dental nerve, to reshape the alveolar crest and normalize the inter-occlusal distance. Survival of the implants is as high as in non-grafted mandibles.