Evaluation of the efficacy of horizontal distraction osteogenesis using expansion screws in the repair of the acquired jaw bone defects

Ann Med Surg (Lond). 2023 Jun 17;85(8):3938-3942. doi: 10.1097/MS9.0000000000000983. eCollection 2023 Aug.

Abstract

Restoration of the segmental defects of the maxilla presents a reconstructive dare to obtain a perfect osseous form and height. A variety of prosthetic and surgical bone grafts exists, that produces less than optimal results. Bone transport distraction is a dependable procedure in several maxillofacial bone defects reconstruction techniques. This study aimed to evaluate the effectiveness of horizontal distraction osteogenesis (DO) using expansion screws for the treatment of atrophic and deficient bone, which is caused by acquired malformations.

Material and methods: A total of eight patients ( age 17-36 years) who came with atrophy of the maxilla were treated by horizontal DO. The used device consisted of two parts: one was an orthodontic expander and the other was a screw-ring. The expansion screws were set on the transport bone, which was osteotomized and fixed to the segments using microscrews. Radiographical documentation of the patients was obtained with cone beam computed tomography prior to the surgery and after 4 months of the distraction phase.

Results: The average of the actual bone gain at the end of the consolidation period was 7 mm (range 5-9 mm). Intraoral DO failed in one patient. The average bone density in the distraction gap after 4 months of the DO was 460.40. The average bone density of the bone defect region after 4 months of the DO was 487.90.

Conclusion: Our results confirm that horizontal DO using expansion screws is a predictable and effective regenerative procedure for patients with acquired bone defects in the jaw.

Keywords: Acquired; distraction osteogenesis; expansion screws; transport segment.