Vertical Alveolar Distraction Osteogenesis of the Atrophic Posterior Mandible Prior to Dental Implant Insertion

Publication date: Available online 21 January 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Adi Rachmiel, Dekel Shilo, Dror Aizenbud, Omri Emodi
PurposeAugmentation of deficient mandibular posterior alveolar ridges poses a great challenge due to extensive bone deficiency and presence of the inferior alveolar nerve. The present study sets its focus on vertical alveolar distraction osteogenesis (ADO) at the posterior mandible prior to dental implant placement.Materials & Methods21 sites in 18 patients with severe mandibular posterior alveolar ridge deficiency were included. A trapezoid osteotomy was performed and an extraosseous alveolar distraction device was fixed and activated following four days of latency period at a rate of 0.5mm/day. Following four month of retention period the distraction device was removed and titanium dental implants were placed.ResultsA mean vertical augmentation of 14.47mm was gained. The newly formed bone was demonstrated using panoramic radiography and CT imaging. 56 dental implants were placed and during a minimum follow-up of 36 months two implants were lost; 96.42% success rate.ConclusionsADO offers significant vertical ridge augmentation with simultaneous soft tissue expansion and stable results. ADO diminishes the need for autogenous bone graft, thus sparing donor site morbidity. ADO of the deficient posterior mandibular alveolar ridge is useful in moderate-severe bony deficiencies and allows for adequate bone formation which allows implant insertion.



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