Dental implants
Alternative Distraction Osteogenesis Technique After Implant Placement for Alveolar Ridge Augmentation of the Maxilla

https://doi.org/10.1016/j.joms.2017.03.007Get rights and content

An alternative technique to reconstruct atrophic alveolar vertical bone after implant placement is presented. The technique consists of distraction osteogenesis or direct surgical repositioning of an implant-and-bone block segment after segmental osteotomies that can be used in esthetic or unesthetic cases. Initially, casts indicating the implant position are obtained and the future ideal prosthetic position is determined to guide the model surgery. After the model surgery, a new provisional prosthesis is fabricated, and an occlusal splint, which is used as a surgical guide and a device for distraction osteogenesis, is custom fabricated. Then, the surgery is performed. For mobilization of the implant-and-bone block segment, 2 vertical osteotomies are performed and then joined by a horizontal osteotomy. The implant-and-bone block segment is moved to the planned position. If a small movement is planned, then the implant-and-bone segment is stabilized; for larger movements, the implant-and-bone segment can be gradually moved to the final position by distraction osteogenesis. This technique has good predictability of the final position of the implant-and-bone segment and relatively fast esthetic rehabilitation. It can be considered for dental implants in regions of vertical bone atrophy.

Section snippets

Technical Note

The technique described in this report can be used for vertical alveolar bone reconstruction, after implant insertion, in the maxilla, and in esthetic or unesthetic regions (Fig 1). Initially, an impression is made using the direct technique (open tray) with a dimensionally stable material, such as regular-body polyvinyl siloxane, and dental stone type IV is poured into this impression to obtain a definitive cast. The casts are mounted in a semiadjustable articulator, and the future ideal

Discussion

An alternative treatment for oral rehabilitation in areas with vertical alveolar bone atrophy is presented. This technique has a lower cost compared with conventional distraction osteogenesis, because the device is made of acrylic resin reinforced with orthodontic wire. It also has good predictability for the final implant-and-bone segment position because of the use of a surgical guide. Another positive aspect of the technique presented is the relatively fast esthetic rehabilitation, because a

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  • Cited by (3)

    • CAD-CAM surgically-guided oral implant site expansion and implant placement in severely atrophic maxilla

      2020, Journal of Taibah University Medical Sciences
      Citation Excerpt :

      These include bone grafting,1,2 guided bone regeneration,3 and distraction osteogenesis.4,5 These methods have several drawbacks such as invasiveness as surgical procedures, resorption of grafting materials, exposure to infection, and delayed implant installation to accommodate grafting maturation.3,6 Referred to as bone spreading or the osteotome technique,7 ridge expansion is a less invasive method for preparing the atrophied ridge for implant placement.

    Conflict of Interest Disclosures: None of the authors have any relevant financial relationship(s) with a commercial interest.

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