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Vertical distraction osteogenesis of fibula transplants for mandibular reconstruction--a preliminary study
Bernd Klesper1, Frank Lazar, Matthias Siessegger
1Department of Maxillo-Facial Surgery, Universität zu Köln, Köln, Germany.
Introduction:
When reconstructing the mandible after tumour resection with a fibular graft, the mandible is often vertically deficient, making placement of dental implants impossible.
Patients:
Segmental vertical distraction of the reconstructed mandible was performed in nine patients following tumour surgery between February 1998 and 2001. Their age was 14-65 years (average 46.3); all underwent radiotherapy with a dose of up to 55.6 Gy prior to tumour resection. Mandibular discontinuity was repaired with a microvascular fibular bone graft. All grafts had a vertical bone deficit ranging from 9 to 12 mm when compared with the non-resected part of the mandibles.
Methods:
All patients underwent segmental vertical distraction of the transplants. The distraction devices were applied intraorally. Distraction of 1.0 mm/day was performed using a Martin distractor (TRACK 1.5) followed by 12 weeks retention time.
Results:
The increase of vertical bone height was stable and enabled placement of dental implants without any complications.
Conclusion:
Vertical distraction osteogenesis may become a common procedure in the treatment of alveolar ridge deficiency resulting from transplanting fibulae for mandibular reconstruction following tumour surgery.