Combined orthodontic temporary anchorage devices and surgical management of the alveolar ridge augmentation using distraction osteogenesis.
OBJECTIVE
Distraction osteogenesis is used to increase the vertical and transverse bone volume of the alveolar ridge and requires 3-dimensional vector controls. Temporary anchorage devices (TADs) may be inserted into the transported segment, enabling distraction vector control by exerting orthodontic force. The authors' aim was to describe a combined orthodontic surgical technique involving vertical alveolar distraction using TADs.


METHODS
Four patients who presented with extensive anterior alveolar ridge bone loss combined with the incisors and canines underwent treatment according to a combined surgical orthodontic protocol, including presurgical orthodontic preparation and a preimplantation surgical augmentation stage involving vertical distractor insertion. During the active vertical alveolar distraction process, 3 TADs were inserted. Intraoral orthodontic elastics were attached to the main orthodontic archwire exerting multidirectional forces to control the vertical distraction vector. After 4 to 5 months of vector controlling and active bone molding, the TADs were removed.


RESULTS
Anterior alveolar ridge augmentation using distraction osteogenesis was achieved. The application of TADs for better anterior segment curvature enabled dental implant insertion, ideal positioning, and restoration.


CONCLUSIONS
A combined surgical orthodontic management protocol involving vertical alveolar distraction osteogenesis for augmentation purposes using TADs enables improved alveolar ridge volume and architecture for the preimplantation stage.
Orthodontic and Craniofacial Department, School of Graduate Dentistry, Rambam Health Care Campus and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel. aizenbud@ortho.co.il
Dror
D
Aizenbud
Hagai
H
Hazan-Molina
Marie
M
Cohen
Adi
A
Rachmiel
D000293:Adolescent; D000328:Adult; D016301:Alveolar Bone Loss / Q000601:surgery; D000539:Alveolar Process / Q000473:pathology; D000540:Alveolar Ridge Augmentation / Q000295:instrumentation / Q000379:methods*; D001861:Bone Regeneration / Q000502:physiology; D003131:Combined Modality Therapy; D003724:Dental Arch / Q000473:pathology / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008437:Maxilla / Q000473:pathology / Q000601:surgery; D052280:Orthodontic Anchorage Procedures / Q000295:instrumentation* / Q000379:methods; D009967:Orthodontic Appliances; D009969:Orthodontic Wires; D019857:Osteogenesis, Distraction / Q000295:instrumentation / Q000379:methods*; D010027:Osteotomy / Q000379:methods; D010347:Patient Care Planning; D019651:Plastic Surgery Procedures / Q000379:methods; D016388:Tooth Loss / Q000534:rehabilitation; D055815:Young Adult