Comparison Between Interpositional Bone Grafting and Osteogenic Alveolar Distraction in Alveolar Bone Reconstruction

Purpose: The aim of this study was to compare the quality and quantity of bone produced by alveolar distraction and interpositional bone grafting. Patients and Methods: Twelve patients requiring alveolar reconstruction were randomly divided into 2 groups. Six patients were treated with alveolar distraction osteogenesis, and 6 were treated with the sandwich osteotomy technique and tibial bone grafting. Bone width and vestibular depth were measured before alveolar reconstruction and after reconstruction. Computed tomography bone densitometry was performed to evaluate the densities of the new bones. Results: In the alveolar distraction group, the mean alveolar bone width and vestibular depth were 10.6 mm and 7.5 mm, respectively, preoperatively. The postoperative values were 10.1 mm and 9.6 mm, respectively. Newly formed bone had a mean density of 512.5 Hounsfield units (HU) compared with 796.3 HU for surrounding bone. In the bone grafting group, the mean alveolar bone width and vestibular depth were 10.5 mm and 7.8 mm, respectively, preoperatively. The postoperative values were 11.5 mm and 6.8 mm, respectively. Newly formed bone had a mean density of 490.6 HU compared with 795.6 HU for surrounding bone. Conclusion: There was no significant difference between the amount of bone width produced by each of the techniques. The changes in vestibular depth were also insignificant. Compared with the surrounding bone, the density of new bone was reduced with both techniques, but the density of the bone graft was significantly lower than the density of bone newly formed by alveolar distraction. (c) 2010 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 68:1853-1858, 2010