Horizontal Distraction Osteogenesis Research Articles

Evaluation of the efficacy of horizontal distraction osteogenesis using expansion screws in the repair of the acquired jaw bone defects.

A total of eight patients ( age 17-36 years) who came with atrophy of the maxilla were treated by horizontal DO. The used device consisted of two parts: one was an orthodontic expander and the other was a screw-ring. The expansion screws were set on the transport bone, which was osteotomized and fixed to the segments using microscrews. Radiographical documentation of the patients was obtained with cone beam computed tomography prior to the surgery and after 4 months of the distraction phase. The average of the actual bone gain at the end of the consolidation period was 7mm (range 5-9mm). Intraoral DO failed in one patient. The average bone density in the distraction gap after 4 months of the DO was 460.40. The average bone density of the bone defect region after 4 months of the DO was 487.90. Our results confirm that horizontal DO using expansion screws is a predictable and effective regenerative procedure for patients with acquired bone defects in the jaw.

A Case of Mandibular Retrusion Treated with Le Fort I Osteotomy and Sagittal-splitting Mandibular Ramus Osteotomy after Correcting Narrow Dental Arch with Maxillo-mandibular Horizontal Distraction Osteogenesis

A Case of Mandibular Retrusion Treated with Le Fort I Osteotomy and Sagittal-splitting Mandibular Ramus Osteotomy after Correcting Narrow Dental Arch with Maxillo-mandibular Horizontal Distraction Osteogenesis

The placement of dental implants in the atrophic jaws with ridge split technique and horizontal distraction osteogenesis. Literature review

The placement of dental implants in the atrophic jaws with ridge split technique and horizontal distraction osteogenesis. Literature review

Use of alveolar distraction osteogenesis for implant placement: a case report with eight‐year follow‐up

Insufficient alveolar ridge width may impede the success of dental implants. Techniques for resolving this problem include autologous bone grafts, guided bone regeneration, bone splitting and bone spreading techniques. Recently, alveolar distraction osteogenesis has become an alternative method for alveolar augmentation. We propose the use of alveolar bone distraction for insufficient alveolar ridge width. A healthy 33-year-old female presented with missing teeth to our clinic. Clinical and radiographic examination revealed the alveolar ridge was too narrow for placement of dental implants. Therefore, horizontal distraction osteogenesis of the posterior mandibular ridge was chosen for augmentation. Two months later, two implants were placed. No significant marginal bone resorption was seen around the implants eight years after placement. Our results indicate that horizontal alveolar distraction is recommended to increase ridge width and allow placement of standard dental implants.

Staged ridge-split evaluated using cone beam computed tomography and peri-implant plastic surgery in the mandibular arch

AbstractLack of sufficient bone to place an implant at a functionally and an esthetically appropriate position is a common problem, especially in the mandibular posterior region. Narrow edentulous alveolar ridges <5 mm wide require bone augmentation before implant placement to establish a bony wall of at least 1 mm around the endosseous implant. Various surgical widening techniques are available, including lateral augmentation with or without guided bone regeneration, ridge-split technique and horizontal distraction osteogenesis. The ridge-split technique aims at creating a new implant bed by longitudinal osteotomy of the alveolar bone. The buccal cortex is repositioned laterally by greenstick fracture, and the space between the buccal and lingual cortices is filled with a graft material. Peri-implant plastic surgery focuses on harmonizing peri-implant structures by means of hard- and soft-tissue engineering and includes bone structure enhancement, soft-tissue enhancement, precision in implant placement and improves quality of the prosthetic restoration. The rationale for the peri-implant plastic surgery approach goes well beyond pure esthetics as it creates peri-implant keratinized mucosa and interimplant soft-tissue height in order to avoid food impaction, interimplant airflow, and speech problems. This case report demonstrates a staged ridge-split technique evaluated with cone beam computed tomography using a piezosurgical unit and a surgical technique to restore a papilla-like tissue at the time of the second-stage implant surgery.

Horizontal alveolar distraction osteogenesis for dental implant: long‐term results

The aim of the present study was to present the results of patients followed for at least 3years who underwent horizontal distraction osteogenesis DO and a final implant prosthesis. A total of 13 sites in 12 patients (three men, nine women; mean age 45.4years, range 21-63years) who presented with severe horizontal atrophy of a partially edentulous maxilla or mandible were treated using horizontal DO. The horizontal distraction device was set on the transport bone which was osteotomized as bone splitting method and fixed to the segment using microscrews. The median of latency period was 9days (range: 7-17); the median of amount of device activation was 5.6mm (range: 4.4-9.6); the median of distraction period was 14days (range: 8-24); and the median of consolidation period, from the end of activation until implant placement, was 13weeks (range: 11-20). The median of actual gain in bone width at the end of the consolidation period was 3.6mm (range: 1.1-5.6). A total of 35 implants were inserted in the augmented area with primary implant stability. The median of follow-up from the start of prosthetic loading was 5.4years. Consequently, the implant survival and success rates were 100% and 94.2%, respectively. This article reports the long-term results of horizontal alveolar DO using a mesh device for patients with an atrophic alveolar region. Our results confirm that this technique is a predictable and effective regenerative procedure for implant preprosthetic treatment in patients with severe horizontal atrophy of the alveolar ridge.

Maxillary Tuberosity Reconstruction with Transport Distraction Osteogenesis

Severe bone loss due to pathology in the maxillary tuberosity region is a challenging problem both surgically and prosthetically. Large bone grafts have a poor survival rate due to the delicate bony architecture in this area and presence of the maxillary sinus. Our case presentation describes a new technique for reconstructing severe bony defect in the maxillary tuberosity with horizontal distraction osteogenesis in a 45-year-old man. A 4 × 6 × 3 cm cyst was discovered in the left maxillary molar region and enucleated. Three months postoperatively, the area had a severe bone defect extending to the zygomatic buttress superiorly and hamular notch posteriorly. Three months later, a bone segment including the right upper second premolar was osteotomised and distracted horizontally. The bone segment was distracted 15 mm distally. After consolidation, implants were placed when the distractor was removed. A fixed denture was loaded over the implants after 3 months. Complete alveolar bone loss extending to the cranial base can be reconstructed with transport distraction osteogenesis. Distalisation of the alveolar bone segment adjacent to the bony defect is an easy method for reconstructing such severe defects.

Histomorphometric Analysis of Delayed Implantation After Horizontal Distraction Osteogenesis of the Mandible in Dogs

Insufficient alveolar width is known to impede successful implantation and is a major obstacle to successful oral reconstruction using intraosseous implants. The aim of this study was to evaluate the osseointegration at implantation after consolidation in distracted narrow alveolar bone. Three adult mongrel dogs weighing 9 to 10 kg were studied. The lower premolars were extracted and horizontal distraction was performed using a distraction device after 8 weeks. Eight weeks after consolidation period, SLA surface implants were installed. The dogs were killed after 4 weeks implantation. The preoperative and postoperative buccolingual widths of alveolar ridge were 2.7 ± 2.1 mm and 4.8 ± 2.5 mm, respectively. Direct bone contact was achieved, with no significant difference in new bone formation observed between implants placed in the distracted and undistracted bone after 4 weeks. It was concluded from this study that horizontal distraction is a useful technique in augmenting a narrow alveolar ridge necessary for implant placement.

Osteosynthesis and simultaneous irregular trifocal distraction osteogenesis for segmental mandibular defect after tumor ablative surgery: a case report

This paper describes a case of secondary mandibular bone reconstruction performed to place dental implants. Osteosynthesis and simultaneous irregular trifocal distraction osteogenesis were documented. The patient was a 51-year-old man with recurrent ameloblastoma of the mandible. Segmental mandibulectomy for tumor ablation and immediate mandibular reconstruction were performed. Because the volume of reconstructed bone was insufficient to place dental implants, trifocal distraction osteogenesis (vertical and horizontal distraction osteogenesis) was performed. Because the mandible had lost its continuity, osteosynthesis was performed simultaneously. Through this procedure, the bone was well augmented. Absorption of the distracted bone was not seen. Adequate-length implants were placed. Irregular trifocal distraction osteogenesis synchronized with osteosynthesis shortened the treatment period and produced stable bone augmentation for placement of dental implants. Therefore, this procedure could be indicated for complicated segmental mandibular bone defects.

Clinical study of horizontal alveolar distraction with modified micro bone screws and subsequent implant placement

The aim of this study was to evaluate the clinical relevance of horizontal distraction osteogenesis (DO) with bone micro screws for reconstructing knife-edge alveolar crests before implant placement. Horizontal DO was performed in upper and lower alveolar crests of seven patients with resorption class IV according to Cawood and Howell. After osteotomy and a 1-week latency period, micro bone screws were reset daily for horizontal expansions by 0.5 mm. Dental implants were placed in the distracted area following a consolidation period of 12 weeks. Computer tomography was performed before DO and implant placement. Morphometric analysis showed a mean gain of 34.01 mm(2) (95% confidence interval [CI]: 10.55-57.48) in bone area and of 3.06 mm (95% CI: 1.81-4.31) in horizontal width, i.e. the horizontal dimension of the alveolus was approximately doubled within the first 5 mm of height. All 12 implants placed into the distracted area fulfilled the success criteria of stable osseointegration after 1 year of functional loading according to Albrektsson and colleagues. Despite the limited number of patients treated, data from the clinical study of horizontal DO with bone micro screws suggest that the generation of sufficient hard tissue in previously knife-edge alveolar crests for subsequent implant placement was possible.

Closure of vertical alveolar bone defects with guided horizontal distraction osteogenesis: an experimental study in pigs and first clinical results

Purpose: To evaluate the option of treating alveolar clefts by guided distraction osteogenesis instead of applying osteoplasty with autologous bone grafts from iliac crest, rib or fibula. Material and Methods: At first, 30 land-bred pigs were operated upon. Treatment of each animal included creating bony defects measuring 2, 4 or 8 mm in the maxilla, anterior to the canine region and up to the nasal periosteum. In 15 of the 30 animals, a new horizontal segment distractor was tested. The device was placed in situ prior to creating an alveolar segment posterior to the defect. This segment was then transported gradually by distraction, thus crossing and closing the defect. At the end of the distraction and stabilization periods the newly formed bony tissue was examined. Results: The critical size of defects was found to be larger than 4 mm. In five of six animals with a horizontal defect of 8 mm, complete ossification of the defect had occurred following distraction osteogenesis. This technique was then applied to five patients successfully. Conclusion: It was shown that distraction osteogenesis is a valid alternative for treating alveolar clefts.