Reconstruction of severe anterior maxillary defects using distraction osteogenesis, bone grafts, and implants

Purpose: The purpose of this article is to describe the method for reconstructing patients with severe anterior maxillary defects, using a combination of distraction osteogenesis, onlay bone grafts, and implants to support either fixed or fixed/removable prostheses. Materials and Methods: The surgical technique involves placement of an extraosseous distraction device followed by greater than 10 mm of distraction of the alveolus. A corticocancellous graft is harvested from the hip to establish sufficient horizontal bone for implant placement. Implants are placed after graft consolidation followed by fabrication of a fixed or fixed/removable prosthesis depending on the needs of the individual patient. Results: Five patients have been prospectively followed using this technique, with completion of their prosthetic reconstruction, with follow-up ranging from 1 to 4 years. Conclusion: The combination of distraction, onlay bone grafting, and implant placement has been able to reconstruct patients with severe maxillary defects. (C) 2005 American Association of Oral and Maxillofacial Surgeons.