Vertical distraction osteogenesis of a nonvascularized iliac bone in a reconstructed mandible: a report of 3 cases

Introduction: Nonvascularized iliac bone grafting is one of the treatment options for mandibular reconstruction. Although nonvascularized bone graft has the advantage of not requiring microsurgery, it does not offer sufficient bone height, making placement of dental implants impossible. We report here 3 patients who underwent vertical distraction osteogenesis of a nonvascularized iliac bone following mandibular resection.

Patients: All patients, 1 men and 2 women 23–37 years old (mean 31.3 years), underwent mandibular resection for treatment of an ameloblastoma. The tumor could be resected with preservation of the periosteum. An iliac corticocancellous bone graft was harvested from the iliac crest and fixed to the basal bone with a reconstruction plate. Bone height of the reconstructed mandible was insufficient to perform functional and esthetic rehabilitation. Therefore, we planned vertical distraction osteogenesis of the reconstructed mandible to obtain sufficient bone height of the alveolar ridge. A box-shaped osteotomy was done for the reconstructed bone. The distraction device was applied intraorally. Distraction of 1.0 mm/day was performed using a KLS Martin alveolar distractor (TRACK 1.5). During the consolidation period, a low-intensity ultrasound device was used in the distracted area to accelerate bone healing. After that period, one patient underwent bone graft harvested from the mandibular ramus to obtain sufficient volume of the alveolar ridge.

Results: Ultimately, all patients received dental implants in the reconstructed bone and acquired adequate esthetics and function of the implant-supported prosthesis.

Conclusion: In conclusion, increasing height of the iliac bone with vertical distraction osteogenesis and placement of dental implants are desirable treatments from functional and esthetic points of view.

Key words: vertical distraction osteogenesis; nonvascularized iliac bone; mandibular reconstruction

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Jan 21, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on Vertical distraction osteogenesis of a nonvascularized iliac bone in a reconstructed mandible: a report of 3 cases
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