Alveolar Distraction for Post-traumatic Atrophic Alveolar Ridge: Evaluation of Bone Height

Objective: To evaluate the stability of alveolar distraction osteogenesis for vertical reconstruction of a severely atrophic and defective alveolar ridge following trauma.Patients and Methods: Nine patients undergoing vertical alveolar distraction osteogenesis performed at 10 sites of post-traumatic atrophy (5 anterior maxilla and 5 anterior mandible) with severe soft tissue scarring were enrolled. Alveolar ridge height was evaluated using digital orthopanoramic X-rays taken shortly after the end of distraction, at consolidation, and before implant placement. For this evaluation, the magnification factor of each X-ray was applied for correction by dividing the actual size of the activation rod by the image size of the activation rod.Results: The mean alveolar distraction achieved at the 10 sites was 9.86 mm (range, 5.07 to 14.80 mm) with ample overcorrection. Sufficient bone and soft tissue had formed at the end of distraction. After a 3-month consolidation period, a vertical bone decrease of 1.94 mm (19.7%) was observed. After 1 additional month for soft tissue healing before implant placement, the vertical alveolar bone decrease was 3.89 mm (39.5%). In total, 25 dental implants were successfully installed in well-regenerated alveolar ridges.Conclusion: Although some bone decrease after alveolar distraction osteogenesis with ample overcorrection was found due to gingival scarring, sufficient bone regeneration for implant placement was achieved in post-traumatic atrophic sites with no complications.