Vertical distraction osteogenesis of fibula transplants for mandibular reconstruction--a preliminary study

J Craniomaxillofac Surg. 2002 Oct;30(5):280-5. doi: 10.1016/s1010-5182(02)90315-x.

Abstract

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.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Alveolar Ridge Augmentation / methods*
  • Bone Transplantation / methods*
  • Carcinoma, Squamous Cell / radiotherapy
  • Carcinoma, Squamous Cell / rehabilitation
  • Carcinoma, Squamous Cell / surgery
  • Dental Implantation, Endosseous
  • Female
  • Fibula / transplantation*
  • Humans
  • Male
  • Mandible / surgery*
  • Mandibular Neoplasms / radiotherapy
  • Mandibular Neoplasms / rehabilitation
  • Mandibular Neoplasms / surgery
  • Middle Aged
  • Osteogenesis, Distraction / methods*
  • Pilot Projects
  • Vertical Dimension