Osteodistraction of the alveolar process

Gaceta Dental. 2002

ABSTRACT

Distraction osteogenesis is a biological process by which bone is formed between two bone fragments that are separated gradually. The new tissue originates only under certain condi- tions, which we will mention later, and which do not alter the physiological phenomena that occur between the fragments.

This active histogenesis occurs not only in the bone but also in skin, muscle, vascular and peripheral nervous tissue. 

Authors present two clinical cases: 

Case 1 (Intraoral extraosseous device) 23-year-old patient with traumatic avulsion of the anterior group in the mandible and bone loss and mandibular fracture, treated with miniplate osteosynthesis. The distraction period was performed by activating the 0.5 mm distraction device (half a turn of the activator), twice a day, to achieve an increase in height of 8 mm.

Case 2 (Intraoral intraosseous device) 56-year-old patient with atrophy in the posterior sector of the lower jaw, with a height of 7 mm from the alveolar ridge to the mandibular canal.

Conclusions:

1. The upper and lower jaw can be expanded in length and width by distraction osteogenesis. The soft tissues accompany them.

2. It distracts vital bone that becomes mineralised early.

3. Resorption is lower than that which occurs in overlapping or interposed grafts.

4. No morbidity of a second surgical field, since it is not necessary to obtain grafts.

5. Intraoral distraction devices have fewer complications and are more comfortable for patients than extraoral ones.

6. The osteodistraction of the deficient alveolar ridge represents an effective and reliable technique for a certain volume of bone mass in a predetermined position on which osseointegrated implants are inserted and proper prosthetic restoration is achieved.

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