Complications and relapse in alveolar distraction osteogenesis in partially dentulous patients.

Vertical distraction of the alveolar process is an efficient method for augmentation prior to inserting dental implants. In this study, complications of this procedure and relapse of the transport segment were evaluated in partially dentulous patients. Twenty patients underwent distraction by means of extraosseous distractors. The location of the defects was the anterior mandible (4), posterior mandible (4), anterior maxilla (10) and posterior maxilla (2). Bone height was measured on panoramic radiographs preoperatively, after distraction and after implant placement at the mesial and distal point of the implant(s). Mean alveolar distraction was 6.5mm at the mesial point (P<0.001) and 6.1mm at the distal point (P<0.001). The mean relapse at the mesial point was 20% and at the distal point 17% (P<0.05). The intraoperative and postoperative problems encountered were fracture (1) and lingual (4) and palatal (6) displacement of the transport segment. Overall complication rate was 55%. Of all implants placed (n=63) one was lost. Implant success rate was 98%. Distraction seems to be a suitable treatment for vertically deficient alveolar bone, but a relatively high although manageable complication rate must be confronted, including considerable relapse.

Use of implants for prosthetic rehabilitation after cancer treatment: clinical experiences.

Treatment of patients with head and neck cancer may result in extensive intra- or extra-oral defects. Prosthetic rehabilitation often will be limited by insufficient retention and an atrophic mucosa or skin. In such cases, osseointegrated implants may offer substantially improved retention for the often complex prosthetic constructions. However, irradiation has a negative influence on the bone growth capacity and thus on osseointegration. Based on experimental studies, a recovery period of 6 to 12 months after irradiation is recommended. Because of the risk of failure and the lack of sufficient and sound scientific knowledge, clinical studies of titanium implants inserted in previously irradiated bone tissue have had varying results. This paper discusses the typical requirements of implant suprastructures for resection prostheses. Some of the patient histories and clinical management presented illustrate the possibilities of implants in the field of maxillofacial reconstruction.