Complications in alveolar distraction osteogenesis of the atrophic mandible.
To improve the starting point for placement of dental implants, 45 patients suffering from atrophied edentulous mandibles, with a vertical height varying between 7.3 and 15.8mm, were treated by alveolar vertical distraction osteogenesis (VDO). The mean follow-up period was 3 years, ranging from 1 to 7 years. Associated complications, as occurred during instalment of the distractor device, VDO period and consolidation phase, and also after dental implant placement, were evaluated. Observed complications were: early fractures (2%), late fractures (17%), bleeding or haematoma (4%), infections (6%), skin perforation (2%), mucosal dehiscence (8%), sensory disturbances (28%), sagging chin (13%) and failure of dental implants (13%). In 10 patients 2 complications and in 1 patient 3 complications were monitored. All complications occurred in the first year. It is concluded that VDO to restore vertical bone height in patients with mandibular atrophy is a surgically delicate technique with a high risk of various complications. The likelihood of the most striking complication, namely fracture occurrence, increases with decreasing residual bone height.
Perdijk
F B T
FB
Department of Oral and Maxillofacial Surgery, Hospital Gelderse Vallei, Ede, The Netherlands. f.perdijk@planet.nl
Meijer
G J
GJ
Strijen
P J van
PJ
Koole
R
R
D000328:Adult; D000368:Aged; D003758:Dental Implantation, Endosseous / Q000009:adverse effects; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008334:Mandible / Q000002:abnormalities / Q000294:innervation / Q000601:surgery*; D008337:Mandibular Fractures / Q000209:etiology; D008875:Middle Aged; D019857:Osteogenesis, Distraction / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D020886:Somatosensory Disorders / Q000209:etiology*; D013529:Surgical Wound Dehiscence / Q000209:etiology*; D013530:Surgical Wound Infection / Q000209:etiology*