Minor complications arising in alveolar distraction osteogenesis.
OBJECTIVE
This study evaluates complications that arise during mandibular alveolar distraction osteogenesis and suggests treatments.


METHODS
We monitored complications that arose during alveolar distraction osteogenesis in 5 patients who underwent a total of 7 distractions, in all cases using an intraosseous distractor (Lead System, Leibinger, Germany). We report our responses to each type of complication.


RESULTS
All 7 distractions were followed by the placement of 2 implants. The restoration was ideal in 4 of the 7 cases and functional but not ideal in the remaining 3. In all 7 distractions, we observed complications, although many were minor complications readily avoided by the use of appropriate technique. The complications were, first, intraoperative complications, namely 1) fracture of the transport segment (1 of 7 cases;


RESULTS
appropriate preventative measures), 2) difficulties in finishing the osteotomy on the lingual side (7 of 7 cases;


RESULTS
use of fine chisels made from cement spatulas), and 3) excessive length of the threaded rod (1 of 7 cases;


RESULTS
cut the rod). Second, complications arose during distraction: 1) incorrect direction of distraction (2 of 7 cases; no corrective measures necessary in the present cases), 2) perforation of the mucosa by the transport segment (2 of 7 cases; response: smooth the crest of the segment with a bone rongeur), and 3) suture dehiscence (1 of 7 cases; no significant implications). Third, there were postdistraction complications, namely bone formation defects (4 of 7 cases; response: guided bone regeneration).


CONCLUSIONS
A number of complications may arise during alveolar distraction osteogenesis. Most of these complications can be considered minor and are readily avoided or resolved by the use of appropriate procedures.
Garcia
Abel Garcia
AG
Department of Maxillofacial Surgery, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain. ciabelgg@usc.es
Martin
Manuel Somoza
MS
Vila
Pilar Gandara
PG
Maceiras
Jacobo Lopez
JL
D003758:Dental Implantation, Endosseous; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D008334:Mandible / Q000601:surgery*; D013516:Oral Surgical Procedures, Preprosthetic / Q000009:adverse effects*; D019857:Osteogenesis, Distraction / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D010027:Osteotomy / Q000009:adverse effects; D011183:Postoperative Complications / Q000517:prevention & control