Contact
Information

Navigation
Introduction
Overview

1. Introduction

2. Historical Perspective

3. Maxillofacial Application

4. The Process

5. The Device

Chapter One
Principles of Alveolar Distraction Osteogenesis
    

     1.  Section I

     2.  Section II

     3.  Section III

     4.  Section IV

     5.  Section V

     6.  Section VI

     7.  Section VII

     8.  Section VIII

     9.  Section IX

   10.  Section X

   11.  Section XI

Chapter Two
Alveolar Distraction Osteogenesis

1. Section I

2. Section II

3. Section III

4. Section IV

5. Section V

6. Section VI

7. Section VII

8. Section VIII

9. Section IX

Chapter Three
Maxillary Alveolar Distraction
Osteogenesis

1. Section I

2. Section II

3. Section III

4. Section IV

5. Section V

6. Section VI

7. Section VII
   

C. A microsaggital saw is used to created a segmental osteotomy to mobilize the deficient alveolar ridge and sound underlying bone. The osteotomy consists of two vertical components which parallel the roots of the adjacent teeth. The length of the vertical osteotomy determines the height of the transport fragment and amount of remaining bone to stabilize the distraction device. If the transport segment is too small, it may fragment during mobilization or resorb. Mobilizing fragments containing only cortical bone should be avoided because they may be predisposed to resorption. If too little bone remains in the stable segment, a fracture may occur during fragment mobilization or later in the transport process.

C.

D. The transport fragment has been outlined with the saggital saw. A small bur may be used to outline the osteotomy but cannot be used to extend the cut through the deep, lingual cortex. A microsaggital or micro-oscillating saw is best to complete the bicortical osteotomy. Saw blades remove a minimal amount of bone in the vertical components of the osteotomy. This is important in the protection of the roots while maximizing the size of the fragment. The horizontal component of the osteotomy may be formed with a saw or bur. Widening the horizontal component with a #703 bur will result in improved access to the lingual cortex to assure a complete osteotomy has been acheived. The additional space is often necessary to correctly position an osteotome used as a lever to mobilize the transport fragment.

D.

E. An osteotome is positioned deeply within the horizontal component of the osteotomy. A combination of rotation and levering of the osteotome mobilizes the fragment. Attempting to mobilize the segment by applying force which is delivered only to the labial cortex may result in fragmentation. If the segment fails to move initially, the completeness of the osteotomy should be verified.

E.

 

Next Section