Vertical distraction of the mandible using a new distraction device: the Verona experience

Alveolar ridge augmentation for preprosthetic surgery has always appeared a challenging treatment. Through years, different surgical techniques as well as natural and synthetic materials, have been provided with the aim of replacing the jaws height. This need has increased even more with the development of the implant surgery as possible procedure to obtain successful long term prosthetic rehabilitation. As fact, implant placement can require the alveolar ridge augmentation to overcome the anatomical limiting factors which come along with the atrophy. Distraction osteogenesis is providing an alternative technique towards alveolar bone reconstruction in preprosthetic surgery. This new concept of treatment was first introduced on animals by Block et al. (1996) and then on humans by Chin and Toth (1996). Up today, distraction osteogenesis is applied in preprosthetic surgery with two different techniques referring to the bony defect to rehabilitate and to the distraction device used. The “Vertical Distraction Osteogenesis” (the “VDO concept”, Hidding et al.,1999), uses intraoral-extraosseus devices placed on the vestibular bony surface. This technique presents a good versatility because of its application to different types of bony defects (Nocini et al.,2000; Chiapasco et al., 2000). The second, the “Alveolar Distraction Osteogenesis”, uses intraosseus devices (Urbani et al.,1999, Kunkel et al.,2000), already developed to become dental implants at the end of the activation (Gaggl et al.,1999). Authors present their experience on VDO of the mandible using a new prototype of distraction device. The surgical technique and the distraction protocol are described as well as main complications occurred and final results.