Distraction osteogenesis to achieve mandibular vertical bone regeneration:A case report

In this case report a surgical technique for vertical ridge augmentation is presented. The procedure, performed in a 30-year-old woman with an atrophi ed alveolar ridge in the anterior portion of the mandible, is based on the biologic concept of osteogenesis distraction previously introduced in ortho pedic and maxillofacial surgery After elevation of a full-thickness flap a horizontal osteotomy was performed 7 to 8 mm from the top of the ridge. Two vertical osteotomies were prepared with drills of increasing diameter (2, 2.8, and 3.25 mm), tapping was performed for the first 5 to 6 mm, and two d istractor base plugs were placed at the base of the osteotomies with a repo sitioning tool. An intraosseous distraction implant was then inserted and 2 inward vertical cuts were made in the bone to allow proper distraction to fake place. Correct functioning of the device was checked by distracting th e bone fragment 7 mm using the axial distraction screw A latency distractio n healing screw was inserted in each of the distraction implants and the ar ea was left to heal for 5 days. Once primary healing had occurred, the dist raction of the newly formed bone callus was activated each day for 10 days (1 mm per day). At the end of the distraction period a final distraction sc rew was left in place and a final healing screw was inserted. During this t ime there were no complications and the patient on no occasion complained o f discomfort. The distractor device was removed 30 days later leaving the b ase plugs in place. One month later a vertical augmentation of 7 mm had bee n achieved; the base plugs were removed, 3 intraosseous implants were inser ted, and a biopsy of the newly formed tissue was obtained. Histologic evalu ation of the biopsy specimen showed woven bone formation approximately 75 d ays after the initial procedure.