title: Multidimensional osteodistraction for correction of implant malposition in edentulous segments.
abstract: This study examined multidimensional osteodistraction as a treatment method for correction of implant malposition and as an alternative to augmentation procedures. The prosthetically unfavourable implant positions were due to growth-related implant malposition (in the context of treatment of young patients with oligodontia) or primary bone-driven implant insertions. The radiographical and clinical findings obtained with this osteodistraction technique are presented and discussed. A tooth-supported osteodistractor for multidimensional distraction with custom-fabricated distraction abutments was used for treatment of 8 patients with a total of 9 maxillary and mandibular edentulous segments including single-tooth gaps. All patients underwent an osteotomy at a minimum distance of 1 mm from the implant surface. Following primary wound healing, distraction was carried out by 1 mm in vertical direction and 0.5 mm in the demanded transverse direction daily until the prosthetically optimized position was achieved. During and after the 12-week retention phase, the patients were evaluated clinically and radiographically. Multidimensional osteodistraction was carried out successfully in all 8 patients. The distraction distances were 3 to 11 mm in vertical direction and a maximum of 5 mm in buccolingual/buccopalatal direction. The malpositioned implants were brought into a prosthetically optimized position in all cases. The results of this study show that this multidimensional osteodistraction technique allows both augmentation of edentulous segments with a clearly compromised implant host site and correction of unfavourable implant positions.
authors.affiliation: Department of Oral Surgery, Dental School of the University of Vienna, Waehringerstrasse 25 a, A-1090 Vienna, Austria.
authors.forename: W
authors.initials: W
authors.lastname: Zechner
authors.forename: T
authors.initials: T
authors.lastname: Bernhart
authors.forename: K
authors.initials: K
authors.lastname: Zauza
authors.forename: A
authors.initials: A
authors.lastname: Celar
authors.forename: G
authors.initials: G
authors.lastname: Watzek
mesh_terms: D000293:Adolescent; D000328:Adult; D000540:Alveolar Ridge Augmentation / Q000379:methods; D000044:Dental Abutments; D015921:Dental Implants; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007576:Jaw, Edentulous, Partially / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008334:Mandible / Q000000981:diagnostic imaging / Q000601:surgery; D008437:Maxilla / Q000000981:diagnostic imaging / Q000601:surgery; D008445:Maxillofacial Development / Q000502:physiology; D008875:Middle Aged; D019857:Osteogenesis, Distraction / Q000295:instrumentation / Q000379:methods*; D010027:Osteotomy / Q000379:methods; D011862:Radiography, Panoramic; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016388:Tooth Loss / Q000503:physiopathology / Q000534:rehabilitation; D016896:Treatment Outcome; D014945:Wound Healing
chemical_list: D015921:Dental Implants