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

Abstract

Augmentation of deficient mandibular posterior alveolar ridges poses a great challenge because of extensive bone deficiency and the presence of the inferior alveolar nerve. This study sets its focus on vertical alveolar distraction osteogenesis (ADO) at the posterior mandible before dental implant placement. The study included 21 sites in 18 patients with severe mandibular posterior alveolar ridge deficiency. A trapezoidal osteotomy was performed, and an extraosseous alveolar distraction device was fixed and activated after a 4-day latency period at a rate of 0.5mm/day. After a 4-month retention period, the distraction device was removed and titanium dental implants were placed. A mean vertical augmentation of 14.47mm was gained. The newly formed bone was shown using panoramic radiography and computed tomography. We placed 56 dental implants, and during a minimum follow-up period of 36months, 2 implants were lost, resulting in a success rate of 96.42%. ADO offers marked 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 to severe bony deficiencies and allows for adequate bone formation, which allows implant insertion.