Besides several conventional therapeutic regimens to treat severe forms of alveolar ridge atrophy the distraction osteogenesis is an alternative method. We introduced a new technique for the treatment of alveolar ridge atrophy encouraged by the advantages of distraction osteogenesis in the last decade. A new technique called "vertical distraction osteogenesis (VDO)" has been developed by our study group to move dentolous and edentolous segments of the alveolar process vertically with a device in microplate-design. Vertical distraction osteogenesis was completed successfully in nine patients with segments length ranging from 6.5 mm to 43 mm with an average of 23.7 mm. The vertical distraction rate was 9.9 mm on average in seven mandibular and two maxillar segments. In all cases we found good stability and the predicted movement of the segments. In contrast to bone transplantation an earlier mineralization in the vertically distracted area could be seen by radiological examination and biopsy. Five patients were treated with dental implants 12 weeks after distraction procedure. Main advantages of vertical distraction osteogenesis are: 1. No bone harvesting, 2. decreased resorption tendency, 3. lower morbidity compared with conventional techniques, 4. lower infection rate and 5. feasibility to insert dental implants 12 weeks after distraction procedure, 6. gain of soft tissue.
Recent reports on orthopaedic surgery focus on mechanical stimulation of the regenerate during distraction therapy of non-unions in long-bone-surgery. In the field of maxillofacial surgery, callus stimulating techniques are rarely reported. The case of a 65-year-old man with a radiogenic mandibular non-union after ablative tumour therapy and pre-operative radiation therapy presented with a non-union. Vertical distraction in combination with subsequent repeated, stepwise compression and distraction (=massage) had a positive effect on the consolidation of the regenerate.
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