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 distr action osteogenesis instead of applying osteoplasty with autologous bone gr afts from iliac crest, rib or fibula. Material and Methods: At first, 30 la nd-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 hori zontal segment distractor was tested. The device was placed in situ prior t o creating an alveolar segment posterior to the defect. This segment was th en transported gradually by distraction, thus crossing and closing the defe ct. At the end of the distraction and stabilization periods the newly forme d 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 distracti on osteogenesis. This technique was then applied to five patients successfu lly. Conclusion: It was shown that distraction osteogenesis is a valid alte rnative for treating alveolar clefts. (C) 2001 European Association for Cra nio-Maxillofacial Surgery.