Prosthetic Rehabilitation of Edentulous Ridges Following Alveolar Distraction Osteogenesis: Clinical Report of Three Cases
Patients with complete edentulism who have insufficient bone for endosseous dental implant treatment present a challenge for dental practitioners. Distraction osteogenesis of the edentulous alveolar ridges is a process for augmentation of atrophic alveolar bone before dental implant placement. This clinical report describes the use of distraction osteogenesis and rehabilitation of patients with a fixed or removable implant-supported prosthesis to treat mandibular defects. Two female patients with segmental alveolar atrophy at the posterior regions of mandible and one female patient with defect at the anterior region of mandible were treated using distraction devices. However, lingual tipping of the distraction vector occurred during the distraction phase in patient 1. The morphology of the alveolar bone was also analyzed in relation to the planned implant position. After a consolidation period of 12 weeks on average, radiologic observation suggested that there was sufficient bone formation for implant installation. In all patients, implant-supported fixed or removable prosthetic oral rehabilitation was successfully performed, and the clinical and radiologic findings were satisfactory. After 4 years of follow-up, no functional or esthetic difficulties with the implants and restorations were noted. These case reports suggest that although alveolar distraction osteogenesis seems to be an effective technique for augmenting atrophic alveolar bone for creating bone and soft tissue, complications may occur after surgical procedures.

(a) Radiograph showing the alveolar deficiency of the patient. (b) Insufficient alveolar crest height of the patient. (c) Radiograph showing the distracted segment. (d) Ball attachments after distraction osteogenesis. (e) Radiograph taken after implant insertion. (f) Intraoral view of the patient at the end of the prosthodontic treatment.

(a) Radiograph showing the alveolar deficiency of the patient. (b) Insufficient alveolar crest height of the patient (left and right side of the mandibula). (c) Radiograph showing the distracted segments. (d) Left and right distractors with plates screwed to the bone and distraction rod placed. (e) Radiograph taken after prosthodontic treatment. (f) Intraoral view of the patient at the end of the prosthodontic treatment.

(a) Radiograph showing alveolar deficiency of the patient. (b) Initial appearance of the patient with removable maxillary and mandibular dentures. (c) Radiograph showing the distracted segment and maxillary implants. (d) Left and right distractors with plates screwed to the bone and distraction rod placed. (e) Radiograph taken after implant insertion. (f) Intraoral view of the patient at the end of the prosthodontic treatment.
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