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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
   

K. As a result of the transport process, the volume of the alveolar housing is increased. The horizontal component of the osteotomy is widened. This space becomes the regeneration chamber which will heal by filling with vital bone. The height of the chamber is initially maintained by the support of the distraction device. After completion of the process of transporting the bone segment, the threaded rod is left in place without activation for three to four weeks. During this time, osseous consolidation occurs across the vertical walls of the osteotomy. The threaded rod is then removed by rotating it in reverse. The formation of mature bone in the regeneration chamber may require months. It is not necessary to wait until the regeneration chamber is completely ossified before osseointegrated implants are placed.

K.

L. Turning the threaded rod results in the translation of the transport plate the elevation of the transport segment. Since the moving bone segment is surrounded by soft tissue, the mucosa is expanded as a result of the gradual movement. The rate of transport is determined by the number of rod rotations and the frequency. The ideal rate depends on the ability of the soft tissue to respond with expansion and regeneration. The periodontal status of the adjacent teeth may also limit the transport rate. In general, a rate of 0.4mm per day is sufficient to allow the soft tissue to respond while avoiding a premature consolidation across the vertical osteotomy components. Premature consolidation is fusion of the osteotomy prior to completion the transport process so that the transport objective has not been achieved. Too slow a distraction rate is one of the causes of premature consolidation.

L.

M. As a result of the distraction process, the alveolar housing has been expanded and reconstructed. The ridge width has been restored. There is expansion of the mucosa including the keratinized gingiva.

PRINCIPLE: The site of regeneration of new bone is distant from the site of pathology. Positioning of the regeneration chamber should place it surrounded by healthy tissues and central to the functional matrix.

M.

 

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