2008 Volume 21 Issue 1 Pages 47-52
Bone grafts and GBR (Guided Bone Regeneration) have been common treatment options for vertical bone mass enhancement. However, they have problems, especially when a large volume of osteogenesis is required, with occasions for bone harvesting, such as: the limited bone mass of the donor site, difficulties in treating soft tissues and the predictability of osteogenesis. Therefore, vertical distraction osteogenesis to improve the deficiency involving both bone and soft tissue has now been adopted and many good results have been reported. However, we have experienced some accidents in cases of implant restoration using vertical distraction osteogenesis of the maxillary anterior region that yielded inadequate results. Here, a summary and review of the case are reported.
A male patient lost 5 maxillary anterior teeth in a traffic accident. Vertical distraction osteogenesis was conducted with a destructor (TRACK 1.0 mm-System), followed by GBR to augment alveolar bone horizontally and then implants were placed. Accidents included: 1) Palatally directed distraction; 2) Asymmetric quantity of distraction due to contact between the transport segment and the underlying bone; 3) Relatively large bone defect remaining in the regeneration chamber; and 4) The mucoperiosteal flap dehisced during the horizontal bone augmentation by GBR.
In actual clinical practice, potential accidents of all kinds should be taken into consideration when planning the treatment, and a review of accidents and countermeasure preparations are important to increase predictability.
