Journal of Oral Implantology October 2014 - (Page 557)

CLINICAL A Simple Solution for Vector Control in Vertical Alveolar Distraction Osteogenesis Ismail Doruk Kocyigit, DDS, PhD1* Hakan H. Tuz, DDS, PhD1 Ozkan Ozgul, DDS, PhD2 Fatih Mehmet Coskunses, DDS, PhD3 Reha S. Kisnisci, DDS, PhD4 One of the important and frequent complications in alveolar distraction osteogenesis is vectorial change of the transport segment. This report presents a simple solution for vector angulation control by placing intermaxillary fixation screws intraoperatively. Advantages of the technique are also discussed. Key Words: alveolar distraction, complication, vector, segment, implant INTRODUCTION A lveolar bone is affected by various pathologies of the jaw. Pathologies that involve bone volume loss may complicate functional restoration and esthetic outcome. In most cases, surgical correction is required to attain a sufficient quantity of bone before the placement of dental implants. Alveolar ridge defects may be reconstructed using several grafting techniques, including guided bone regeneration, onlay grafting, and interpositional grafting.1-4 Recently, augmentation of the alveolar bone using distraction osteogenesis has become a useful alternative to grafting.5,6 Distraction adds new bone to the alveolar process while enabling the neogeneration of surrounding soft tissue through a mechanism referred to as distraction histogenesis.7 Vertical alveolar distraction (VAD) adds an adequate amount of bone along with the required soft tissue. To ensure that new bone is positioned suitably for 1 Department of Oral and Maxillofacial Surgery, Kirikkale University, Kirikkale, Turkey. 2 Department of Oral and Maxillofacial Surgery, Ufuk University, Ankara, Turkey. 3 Gumussuyu Military Hospital, Istanbul, Turkey. 4 Department of Oral and Maxillofacial Surgery, Ankara University, Ankara, Turkey. * Corresponding author, e-mail: DOI: 10.1563/AAID-JOI-D-12-00018 implant placement, it is essential for the distraction device to be properly aligned. However, special care must be taken to control the vector of movement during distraction because even if the distractor is correctly orientated, it is not uncommon for the bone to be misdirected due to the forces exerted by surrounding muscle and tight connective tissue, especially in the symphyseal and maxillary regions.8 This study describes the intraoperative placement of intermaxillary fixation screws (IMFSs) as a method of vector control that can be used to direct angulation of the segment during alveolar bone distraction. PATIENTS AND METHODS VAD surgery was performed before implant placement on 3 patients (2 male, 1 female; age range, 22- 54 years) with insufficient alveolar bone height due to periodontal tooth loss (1 patient); an unsatisfactory, postcancer-surgery iliac crest bone graft (1 patient); and periodontal-related tooth loss, multiple impacted teeth, and cyst surgery (1 patient), as shown in Table 1. Distraction was initiated at 5-7 days postsurgery, with a rate of 1 mm/day. Total distraction amounts ranged between 12 and 20 mm. Implant surgery for implant-supported fixed prosthetics was performed after a consolidation period of at least 12 weeks. Journal of Oral Implantology 557

Table of Contents for the Digital Edition of Journal of Oral Implantology October 2014

New AAIP Affiliates Increase JOI Readership
Letter to the Editor
Bone Response From a Dynamic Stimulus on a One-Piece and Multi-Piece Implant Abutment and Crown by Finite Element Analysis
Effect of Platelet-Rich Plasma on the Healing of Mandibular Defects Treated With Fresh Frozen Bone Allograft: A Radiographic Study in Dogs
Efficacy of Growth Factor in Promoting Early Osseointegration
Assessment of Candida Species Colonization and Denture-Related Stomatitis in Bar- and Locator-Retained Overdentures
A Simple Solution for Vector Control in Vertical Alveolar Distraction Osteogenesis
Maxillary Ridge Augmentation With Custom-Made CAD/CAM Scaffolds. A 1-Year Prospective Study on 10 Patients
A Retrospective 3- to 5-Year Study of the Reconstruction of Oral Function Using Implant- Supported Prostheses in Patients With Hypohidrotic Ectodermal Dysplasia
Effects of a New Implant Abutment Design on Peri-Implant Soft Tissues
Repair Technique for Fractured Implant-Supported Metal-Ceramic Restorations: A Clinical Report
Full-Mouth Rehabilitation for a Patient With Dentinogenesis Imperfecta: A Clinical Report
New Method to Increase Inter-alveolar Height With Preservation of Crestal Cortical Bone for Implant Treatment
Implant Placement With a Guided Surgery System Based on Stress Analyses Utilizing the Bone Density: A Clinical Case Report
A Novel Technique for Osteotome Internal Sinus Lifts With Simultaneous Placement of Tapered Implants to Improve Primary Stability
Maxillary Sinus Augmentation and Implant Placement Using Venous Blood Without Graft Material: A Case Letter
Modification of Maxillary Sinus Floor With Orthodontic Treatment and Implant Therapy: A Case Letter
A Surgical Guide for Optimal Placement and Immediate Restoration of Implant
Osseointegrated Dental Implants in Growing Children: A Literature Review

Journal of Oral Implantology October 2014