A new morphologic classification of the alveolar ridge after distraction osteogenesis in human patients. A 17 years retrospective case series study / Una nueva clasificación morfológica de la cresta alveolar después de la distracción osteogénesis en pacientes humanos. Un estudio de serie de casos retrospectivo de 17 años

ABSTRACT

Background: To perform a morphologic classification based on the results of bone augmentation after a distractionosteogenesis.Material and Methods: Thirty-four (34) patients (24 women and 10 men; mean age, 47.1 years (SD=9.5); age range,23 to 62 years) underwent a total of 42 alveolar ridge distractions before the placement of a total of 89 dentalimplants. Ridge bone morphology was evaluated as the main ordinal variable. Chi-squared, Kruskal-Wallis andANOVA one-way test were used.Results: Category I (30.95%) consisted of wide alveolar rim and no bone defects Category II (28.57%) widealveolar rim, lateral bone surface concavity. Category III (23.81%) narrow alveolar rim, lateral bone surface con-cavity. Category IV (2.38 %) distraction transport segment forming a bridge, without bone formed beneath andrequiring guided bone regeneration. Category V (9.52%) return of the transport segment to its initial position dueto the reverse rotation of the distractor screw. Category VI (4.76 %) distraction transport segment completely lost.Subcategory D (28.57%), consisted of lingual deviation of the distraction axis, occurring in any of the categories Ito IV. More men (76.9 %) presented with category I (p<0.001). The use of the chisel resulted mainly in categories I and II (69.4 %) (p<0.001). GBR was only required in 23.1 % of the cases in Category I (p=0.011). The bone heightachieved decreases as the category increases, due to the accompanying osteogenic limitations (p<0.001). The im-plants placed in category I were longer 11.5 ± 0.9 mm (CI95% 10.9-11.9 mm) compared to those placed in categoryIII with a length of 10.4 ± 1.5 mm (CI95% 9.5-11.4 mm) (p=0.035).Conclusions: The alveolar ridge after distraction osteogenesis could be divided into six morphologic categorieswhich provide a useful basis for decision-making regarding implant placement.(AU)