Implant installation using vertical distraction osteogenesis at a severely atrophied edentulous mandible

ABSTRACT

OBJECTIVES: It is difficult to place implants at a severely atrophied edentulous mandible because of vertical and horizontal alveolar defect. The autogenous and allogenic bone graft and guided bone regeneration are useful, but there are some limitations such as the resorption and infection of the grafted bone, and insufficiency of soft tissue. Distraction osteogenesis has recently evolved a challenging technique to overcome major draws of conventional augmentation procedures, we, therefore, report the four applications of implant placement after vertical alveolar distraction osteogenesis. PATIENTS AND METHODS: Four patients(all female, mean age 60+/-6 years) with severe alveolar ridge deficiencies at their anterior mandible were treated with vertical alveolar distraction osteogenesis by intraoral device(Track 1.5, 15 mm model, KLS Martin, Tuttlingen, Germany) and placement of implants (Branemark MK III, TiUnite). After the latency periods of 5, 7, 8 days, distraction rhythm and rate were 0.5 mm*2 times/day in the case of good bone quality, and 0.25 mm*3 times/day in the case of poor bone quality. After consolidation periods of mean fifteen weeks, five implants for each patients were placed at the interforaminal area. RESULTS: On average, a vertical gain of 11.38+/-1.38 mm was obtained by distraction. And all distraction zone showed complete ossification by panoramic radiography. There were no postoperative complications other than numbness of lower lip in one case. Total twenty implants in four patients were placed and their outcomes were satisfactory. CONCLUSION: It is a useful method to place five implants after vertical distraction osteogenesis of the severely atrophied mandible for the implant-supported fixed prosthesis.