Vertical distraction osteogenesis of fibula transplants for mandibular reconstruction – a preliminary study

Abstract

Introduction: When reconstructing the mandible after tumour resection with a fibular graft, the mandible is often vertically deficient, making placement of dental implants impossible. Patients: Segmental vertical distraction of the reconstructed mandible was performed in nine patients following tumour surgery between February 1998 and 2001. Their age was 14–65 years (average 46.3); all underwent radiotherapy with a dose of up to 55.6 Gy prior to tumour resection. Mandibular discontinuity was repaired with a microvascular fibular bone graft. All grafts had a vertical bone deficit ranging from 9 to 12 mm when compared with the non-resected part of the mandibles. Methods: All patients underwent segmental vertical distraction of the transplants. The distraction devices were applied intraorally. Distraction of 1.0 mm/day was performed using a Martin ® distractor (TRACK 1.5) followed by 12 weeks retention time. Results: The increase of vertical bone height was stable and enabled placement of dental implants without any complications. Conclusion: Vertical distraction osteogenesis may become a common procedure in the treatment of alveolar ridge deficiency resulting from transplanting fibulae for mandibular reconstruction following tumour surgery. Copyright Published by Elsevier Science Ltd. on behalf of European Association for Cranio-Maxillofacial Surgery