Distraction Osteogenesis in an Anterior Mandibular Bone Defect Utilizing Lingual Periosteal Release: A Case Report

This clinical report presents a modified distraction technique to achieve height in the vector of distraction. The success of distraction osteogenesis depends on both biologic and biomechanical factors. The focus in this case is on correcting the direction of distraction; incorrect distraction direction is a frequent complication associated with distraction osteogenesis in the mandible. A 21-year-old man presented with a 10-mm vertical bone defect in the anterior mandible caused by facial trauma. The treatment chosen was distraction osteogenesis. After osteotomizing a bone segment and slitting the lingual periosteum, the bone segment was advanced anteriorly 4 mm and an extra-alveolar distraction device was applied. This approach allows the distraction device to be placed vertically, thus preventing lingual shift. The newly created alveolar ridge fully met prosthodontic requirements for a predictable outcome.