Osteodistraction

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Bilateral alveolar ridge augmentation
in mandible by distraction osteogenesis.

Niels Gersel Pedersen, DDS DR.ODONT (ngp@scicomserv.dk)
Clinic of Oral & Maxillofacial Surgery
Lille Strandstræde 10, st.th.
1254 Copenhagen K., DENMARK.

Distraction osteogenesis has some advantages compared to other bone augmentation procedures in mandible. No donor sites.
Shortening of treatment time before implant can be placed in the augmented bone. Simultaneous lengthening of soft tissue.

Case presentation:

53 - year old man with bilateral mandibular alveolar ridge atrophy due to Juvenile Periodontitis. Tooth loss includes lower molars right side / one lower premolar and molars left side. Residual alveolar ridge height over mandibular nerve 7-8 mm.

Plan of treatment.

1) To augment alveolar ridge 7 mm and
2) To place two implants on each side.

Procedure performed in local anesthesia.
Alveolar ridge exposed through vestibulary incision. Mucoperiostal flap elevated. The regions of the vertical and horisontal osteotomy sites exposed. Mental nerve identified and preserved.

The necessary length of alveolar ridge to be augmented is 18 mm. Vertical osteotomy begin 2 mm distally to remaining teeth. Heigth of vertical cut 6 mm.

Adaption of the distractor is performed by bending the microplates (essentially the lower one) to get the right vertical vector of distraction. Get the direction straight towards planned position, avoid the lingual direction and interference with occlusion.

Requires
QuickTime

A Track 1.0 mm Distractor length 9 mm is applied and a temporarily fixation by two 1 mm or 1.2 mm monocortical screws (length 4 mm or 5 mm) is made. The direction and height of horizontal cut is marked out, the distractor removed and the osteotomy carried through with burr and chisel.


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