ABSTRACT
We describe the utilization of distraction osteogenesis in the free fibular microvascular
bone graft to the mandible for increasing bone height for future osseointegrated dental
implants. Successful reconstruction of a resected mandible requires restoration of
both function and esthetic form. Although current reconstructive techniques restore
anterior-posterior and lateral projection, often the graft's vertical height is not
sufficient for the placement of osseointegrated dental implants and subsequent oral
prosthesis. The patient was a sixteen-year-old male who was found to have a large
desmoplastic fibroma of the left mandible, which was resected. The defect was successfully
restored with a free fibular microvascular bone graft and reconstruction plate. Nevertheless,
the patient had persistent problems with mastication and it was decided to perform
a segmental osteotomy of the neomandible. Two internal vertical distraction devices
were then placed in the mandible. The appliances were then activated five days postoperative,
twice a day, for a total of 14 days. At that time 1.5 cm of distraction had occurred
and the patient was placed in a consolidation phase for four months. The patient then
had sufficient bone height and was restored with 8 osseointegrated dental implants.
KEYWORDS
Alveolar distraction - fibula graft - dental implants - mandibula reconstruction
