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Anterior alveolar segmental osteodistraction with a bone-borne device: clinical and radiographic evaluation


Metzler, Philipp; Obwegeser, Joachim Anton; Jacobsen, Christine; Zemann, Wolfgang (2012). Anterior alveolar segmental osteodistraction with a bone-borne device: clinical and radiographic evaluation. Journal of Oral and Maxillofacial Surgery, 70(11):2549-2558.

Abstract

PURPOSE: Anterior alveolar osteodistraction is a common method for enlargement of the dentoalveolar process, and bone-borne distraction devices are hypothesized to avoid the risk of dental tipping and periodontal impairment during distraction. The aim of this study was to objectify this thesis and to determine the reliability of bone-borne osteodistraction of the anterior alveolar process. PATIENTS AND METHODS: The study group consisted of 18 consecutive patients who underwent anterior alveolar segmental distraction with a bone-borne distraction device for the treatment of dental crowding or alveolar retrusion from 2008 through 2011. Clinical and radiologic changes within the apical base and dentoalveolar process were analyzed after bone-borne distraction osteogenesis. All measurements were carried out using cone-beam computed tomography. RESULTS: Surgery and the postoperative period were uneventful in all patients. Mean alveolar movement was 8.2° ± 2.4°. Skeletal movement was 97.6% and absolute dental tipping was 2.4%. A mean change in the occlusal plane of 1.9° ± 1.1° was verified. The apical base enlargement showed a mean of 7.9 ± 1.4 mm, and the dentoalveolar arch a mean increase of 12.7 ± 2.1 mm. Within the distraction zone, a mean vertical bone loss of 3.5 ± 0.7 mm and a mean horizontal bone loss of 3.9 ± 0.8 mm were seen. After orthodontic gap closure, both were clinically irrelevant, with no need for additional bone grafts. Periodontal impairment (gingival recessions of 1 mm) was observed in 7 patients but affected only the teeth bordering the vertical osteotomy line. CONCLUSIONS: Bone-borne anterior alveolar osteodistraction is sufficient for enlargement of the apical base and the dentoalveolar arch of the mandible. Skeletal movement of the alveolar segment was predictable and dental tipping was clinically irrelevant. This technique presents further indications and approaches in orthognathic surgery.

Abstract

PURPOSE: Anterior alveolar osteodistraction is a common method for enlargement of the dentoalveolar process, and bone-borne distraction devices are hypothesized to avoid the risk of dental tipping and periodontal impairment during distraction. The aim of this study was to objectify this thesis and to determine the reliability of bone-borne osteodistraction of the anterior alveolar process. PATIENTS AND METHODS: The study group consisted of 18 consecutive patients who underwent anterior alveolar segmental distraction with a bone-borne distraction device for the treatment of dental crowding or alveolar retrusion from 2008 through 2011. Clinical and radiologic changes within the apical base and dentoalveolar process were analyzed after bone-borne distraction osteogenesis. All measurements were carried out using cone-beam computed tomography. RESULTS: Surgery and the postoperative period were uneventful in all patients. Mean alveolar movement was 8.2° ± 2.4°. Skeletal movement was 97.6% and absolute dental tipping was 2.4%. A mean change in the occlusal plane of 1.9° ± 1.1° was verified. The apical base enlargement showed a mean of 7.9 ± 1.4 mm, and the dentoalveolar arch a mean increase of 12.7 ± 2.1 mm. Within the distraction zone, a mean vertical bone loss of 3.5 ± 0.7 mm and a mean horizontal bone loss of 3.9 ± 0.8 mm were seen. After orthodontic gap closure, both were clinically irrelevant, with no need for additional bone grafts. Periodontal impairment (gingival recessions of 1 mm) was observed in 7 patients but affected only the teeth bordering the vertical osteotomy line. CONCLUSIONS: Bone-borne anterior alveolar osteodistraction is sufficient for enlargement of the apical base and the dentoalveolar arch of the mandible. Skeletal movement of the alveolar segment was predictable and dental tipping was clinically irrelevant. This technique presents further indications and approaches in orthognathic surgery.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Division of Surgical Research
04 Faculty of Medicine > Center for Dental Medicine > Clinic for Cranio-Maxillofacial Surgery
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:November 2012
Deposited On:06 Feb 2013 18:11
Last Modified:05 Apr 2016 16:28
Publisher:Elsevier
ISSN:0278-2391
Publisher DOI:https://doi.org/10.1016/j.joms.2012.07.023
PubMed ID:23078822

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