Distraction osteogenesis of the nasal and antral osseous floor to enhance alveolar height

Abstract

The purpose of the study was to obtain information on the possibility of using distraction osteogenesis (DO) to increase the height of posterior atrophic maxillary alveolar ridges by distracting very small alveolar crest bone segments and, secondly, to determine if it is possible to distract the bony antral floor itself, producing new bone between the sinus membrane and the alveolar crest. Three adult Papio anubis baboons were rendered edentulous in the posterior maxilla. Bilateral osteotomies were performed to produce a thin margin of crestal alveolar bone and in one area, a complete exposure of the antral floor. Distractors were placed against the antral and nasal floors and the thin 1- x 1.5-mm thick alveolar bone crest was distracted 10 mm over a period of 10 days. Animals were labeled with tetracycline at 3 and 4 months and were sacrificed at 5 months. A complete osseous regeneration of the nasal floor and alveolar ridge greater than 10 mm in height was produced in all cases. Histomorphometric analysis of the DO-induced osseous areas revealed cancellous bone with increasing thickness during the third and fourth month and formation of new bone cortices increasing in thickness during the same time. Significant new bone also formed in the antral floor areas that had been purposely interdicted by the osteotomies. The results of this study indicate that very small segments of bone of the posterior maxilla can be distracted to produce significant increases in the alveolar bone height and that a new osseous nasal-antral floor enhancement can be produced by this technique.