Vertical distraction osteogenesis of fibula transplants for mandibular reconstruction--a preliminary study.
BACKGROUND
When reconstructing the mandible after tumour resection with a fibular graft, the mandible is often vertically deficient, making placement of dental implants impossible.


METHODS
Segmental vertical distraction of the reconstructed mandible was performed in nine patients following tumour surgery between February 1998 and 2001. Their age was 14-65 years (average 46.3); all underwent radiotherapy with a dose of up to 55.6 Gy prior to tumour resection. Mandibular discontinuity was repaired with a microvascular fibular bone graft. All grafts had a vertical bone deficit ranging from 9 to 12 mm when compared with the non-resected part of the mandibles.


METHODS
All patients underwent segmental vertical distraction of the transplants. The distraction devices were applied intraorally. Distraction of 1.0 mm/day was performed using a Martin distractor (TRACK 1.5) followed by 12 weeks retention time.


RESULTS
The increase of vertical bone height was stable and enabled placement of dental implants without any complications.


CONCLUSIONS
Vertical distraction osteogenesis may become a common procedure in the treatment of alveolar ridge deficiency resulting from transplanting fibulae for mandibular reconstruction following tumour surgery.
Klesper
Bernd
B
Department of Maxillo-Facial Surgery, Universität zu Köln, Köln, Germany.
Lazar
Frank
F
Siessegger
Matthias
M
Hidding
Johannes
J
Zöller
Joachim E
JE
D000293:Adolescent; D000328:Adult; D000368:Aged; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D016025:Bone Transplantation / Q000379:methods*; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy / Q000534:rehabilitation / Q000601:surgery; D003758:Dental Implantation, Endosseous; D005260:Female; D005360:Fibula / Q000637:transplantation*; D006801:Humans; D008297:Male; D008334:Mandible / Q000601:surgery*; D008339:Mandibular Neoplasms / Q000532:radiotherapy / Q000534:rehabilitation / Q000601:surgery; D008875:Middle Aged; D019857:Osteogenesis, Distraction / Q000379:methods*; D010865:Pilot Projects; D014716:Vertical Dimension