Combined Orthodontic Temporary Anchorage Devices and Surgical Management of the Alveolar Ridge Augmentation Using Distraction Osteogenesis

Vertical Alveolar Distraction Osteogenesis of the Atrophic Posterior Mandible Before Dental Implant Insertion

“…ADO results in formation of alveolar bone by traction of 2 bony segments, thus producing adequate height for implant placement, which allows restoration of function and proper occlusion. [19][20][21]28 In mild alveolar bone deficiency, up to 7 mm, autogenous bone graft either by onlay bone graft or by inlay bone graft (sandwich osteotomy) is adequate with the advantage of a single-stage operation. However, in cases of moderate to severe deficiency of over 7 mm, ADO offers greater elongation with simultaneous soft tissue expansion and stable results while sparing the use of autogenous bone graft and related morbidity.…”

“…However, in cases of moderate to severe deficiency of over 7 mm, ADO offers greater elongation with simultaneous soft tissue expansion and stable results while sparing the use of autogenous bone graft and related morbidity. [19][20][21]28 Chiapasco et al 34 compared GBR with ADO in cases of vertical alveolar deficiency for up to 3 years after prosthetic loading of implants. The findings indicated that alveolar distraction offers more predictable long-term results for vertical-height bone augmentation.…”

“…When applying ADO, one must pay attention to the direction of elongation, as well as the stability of the crestal transported segment, and must allow for a sufficient retention period and thus maturation of the newly formed bone with correct timing of dental implant placement. [19][20][21]37 It is imperative to correctly place the incision for flap elevation because it affects the quality of the regenerated bone at the end of the procedure. The buccal paracrestal incision along with preservation of the crestal and lingual mucosal attachment ensures proper perfusion to the crestal transported bone, thus minimizing resorption and impairment of neighboring structures.…”

“…For this reason, the use of distraction osteogenesis (DO) for alveolar bone augmentation has increased gradually during the past 2 decades. [19][20][21] In DO an osteotomy or corticotomy is performed, and gradual expansion of the gap between the bone segments induces bone formation. 22,23 Ilizarov 22,23 described the tension-stress effect on formation of bone and surrounding tissues and also stressed the importance of loading and blood perfusion for the contouring of joints and bones.…”

Controlling the vector of distraction osteogenesis in the management of obstructive sleep apnea

“…We previously described the usage of TADs to control the vector of distraction for restoration purpose[27] and for alveolus deficiency due to cleft palate. [28] TADs were also used for controlling midface advancement through Le Fort III and monobloc distraction osteogenesis.…”