The transgingival approach for placement of distraction implants

Purpose: Since 1997, distraction implants have been clinically used for alveolar ridge distraction and, later, for prosthetic treatment. While 63 patients have been treated by the authors by alveolar ridge distraction with distraction implants with an open approach, the aim of this study was to demonstrate a minimally invasive technique of distractor placement via a transgingival approach. Patients and Methods: Twelve patients were treated with a modified surgical incision using distraction implants. A tissue punch was used to remove transgingival mucosa, and a segmental osteotomy was performed using a vestibular incision. The distracted segment was pedicled at the lingual and crestal mucoperiosteum. Distraction was carried out for 0.5 mm per day, divided into 2 to 4 turns per day. A distraction of 5 to 7 mm was performed. At the end of distraction, the distraction insert was changed into a definitive stable implant insert. Prosthetic treatment was performed 4 months after the distraction period with fixed superstructures. The follow-up was performed with the aid of dental radiographs, evaluation of peri-implant probing depths, and Periotest values (Siemans, Bensheim, Germany). Results: The outcome of this technique showed minimal scarring of the gingiva with good aesthetic results, the clinical and radiologic findings were satisfying, and the Periotest values were negative at every examination. The rate of complications was low. Conclusion: Minimal scarring and good aesthetic and functional outcome resulted in patients with alveolar ridge distraction performed with a transgingival approach. © 2002 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 60:793-796, 2002