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.
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
Gerry M
GM
Raghoebar
Kees
K
Stellingsma
Henny J A
HJ
Meijer
Arjan
A
Vissink
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