Alveolar distraction osteogenesis of a fibula free flap in maxillary reconstruction

In maxillary reconstruction, it is challenging to obtain satisfactory maxillary projection and to optimizate the dental implant-prosthetic rehabilitation. We report a case of sagittal distraction of a fibula free flap used to reconstruct maxilla after a ballistic trauma. Distraction began seven days after implantation of the device. The distraction protocol was 0.9mm per day during a total period of 2 months. Cone beam computed tomography acquisitions were performed at 3 months after the end of the distraction. The distractor device was removed 5 months after the end of the distraction protocol to allow bone consolidation. A satisfactory total distraction of 7mm was obtained with an esthetic variation of the projection of the upper lip and closure of the nasolabial angle.