Vertical distraction of the severely resorbed edentulous mandible: an assessment of treatment outcome.
OBJECTIVE
To assess the treatment outcome (implant survival, surgical complications, patient satisfaction) of vertical distraction of the severely resorbed edentulous mandible.


METHODS
Forty-six patients with severe resorption of the edentulous mandible (bone height 5 to 8 mm, median 6 mm) participated in this study. The anterior segment of the mandible was vertically augmented using the Groningen distraction device. One or 2 months after the last day of distraction, 2 implants (n = 92) were placed. Standardized clinical and radiographic assessments were performed annually, and patient satisfaction was scored on a 10-point rating scale (0 = completely dissatisfied; 10 = completely satisfied).


RESULTS
Three implants were lost during the healing phase, but none were lost for the rest of the follow-up period (72 +/- 10.3 months), resulting in an implant survival rate of 97%. One patient developed a fracture of the mandible 3 days after the last day of distraction; it healed uneventfully. The mean mandibular bone resorption during follow-up as measured on radiographs in the midline and distal of the implants was 9.8% +/- 0.6% and 10.2% +/- 0.8%, respectively. In 4 patients radiolucency in the distracted area persisted during the follow-up period. Four patients reported a slight sensory disturbance at the final evaluation visit. All patients functioned well with their prostheses. The mean patient satisfaction score after treatment was 8.1 +/- 1.2.


CONCLUSIONS
Vertical distraction of the anterior segment of a severely resorbed alveolar ridge of the mandible can provide a proper basis for insertion and osseointegration of endosseous load-bearing implants with good implant survival, few surgical complications, and good patient satisfaction.
Raghoebar
Gerry M
GM
Department of Oral and Maxillofacial Surgery and Maxillofacial Prosthetics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. g.m.raghoebar@kchir.umcg.nl
Stellingsma
Kees
K
Meijer
Henny J A
HJ
Vissink
Arjan
A
D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D003758:Dental Implantation, Endosseous; D015921:Dental Implants; D019232:Dental Restoration Failure; D005260:Female; D006801:Humans; D007180:Incisor; D007575:Jaw, Edentulous / Q000601:surgery*; D008297:Male; D008334:Mandible / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D019647:Oral Surgical Procedures / Q000379:methods*; D019857:Osteogenesis, Distraction / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D011859:Radiography; D016896:Treatment Outcome; D014716:Vertical Dimension
D015921:Dental Implants