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mandibular distraction osteogenesis

Seung-Hak Baek, Yoon-Hee Park, Jee Hyeok Chung, Sukwha Kim, Jin-Young Choi
The purpose of this case report was to introduce the concept of orthodontic and orthopedic treatment for a growing patient with Tessier number 0 cleft. A 5-year-old boy patient with Tessier number 0 cleft presented congenitally missing maxillary central incisors (MXCI), a bony defect at the premaxilla, a constricted maxillary arch, an anterior openbite, and maxillary hypoplasia. His treatment was divided into three stages: management of the bony defect at the premaxilla and the congenitally missing MXCIs using a fan-type expansion plate, iliac bone grafting, and eruption guidance of the maxillary lateral incisors into the graft area for substitution of MXCIs; management of the maxillary hypoplasia using sequential facemask therapy with conventional and skeletal anchorage; and management of the remaining occlusal problems using fixed orthodontic treatment...
March 2018: Korean Journal of Orthodontics
Ying-Hua Zhao, Shi-Jian Zhang, Zi-Hui Yang, Xiao-Chang Liu, De-Lin Lei, Jing Li, Lei Wang
Distraction osteogenesis is an important technique for the treatment of maxillofacial abnormities and defects. However, distraction osteogenesis may cause the injury of the inferior alveolar nerve. The relationship between distraction rate and nerve degeneration-regeneration shift remains poorly understood. In this study, 24 rabbits were randomly divided into four groups. To establish the rabbit mandibular distraction osteogenesis model, the mandibles of rabbits in distraction osteogenesis groups were subjected to continuous osteogenesis distraction at a rate of 1...
February 2018: Neural Regeneration Research
Katherine E Hicks, Kathleen R Billings, Chad A Purnell, John M Carter, Bharat Bhushan, Arun K Gosain, Dana M Thompson, Jeffrey C Rastatter
PURPOSE: Airway management in neonates with Pierre Robin sequence (PRS) can be challenging. The goal was to describe the algorithm developed by the authors over the past 8 years. METHODS: A retrospective case series analyzing airway management in neonates with PRS admitted to the neonatal intensive care unit at a tertiary care pediatric hospital was performed. The utility of the proposed algorithm for airway management incorporating more consistent use of polysomnography (PSG), and airway assessment was assessed...
March 16, 2018: Journal of Craniofacial Surgery
Cyril S Gary, Sharon Marczewski, Patricia M Vitagliano, Rajendra Sawh-Martinez, Robin Wu, Derek M Steinbacher
Mandibular distraction osteogenesis (MDO) is an effective treatment modality for children suffering from upper airway obstruction from Robin Sequence (RS). Mandibular distraction osteogenesis has been shown to have positive effects on oral feeding and for relieving respiratory obstruction, but its effects on postoperative weight gain are poorly understood. This study quantitatively analyzes weight gain following MDO. A retrospective chart review identified 22 RS children who underwent MDO. Patient weight data, feeding methods pre- and postoperatively, and polysomnography data pre- and postoperatively were collected...
March 16, 2018: Journal of Craniofacial Surgery
Abdullah Tahir Şensoy, Irfan Kaymaz, Ümit Ertaş, Ali Kiki
PURPOSE: The purpose of this study is to suggest a patient-specific osteotomy line to optimize the distractor position and thus to minimize the disadvantages of conventional mandibular distraction osteogenesis (MDO) protocols. In addition, this study also aims to compare the conventional MDO protocols with the new MDO protocol proposed in this study in terms of both orthodontic outcomes and mechanical effects of osteotomy level on callus stabilization by means of the finite element method...
March 8, 2018: Journal of Craniofacial Surgery
Rodrigo Fariña, Loreto Canto, Renato Gunckel, Juan Pablo Alister, Francisca Uribe
: Temporomandibular joint ankylosis, according to age of onset, causes severe functional and morphological disorders, as well as stunted craniofacial growth and development.The primary goal of treatment is to resolve the functional and morphological disorders. METHOD: Pre- and posttreatment clinical and cephalometric registries were conducted in 15 patients with temporomandibular joint ankylosis over a 10-year period (2002-2012). All the patients underwent complete removal of the ankylotic block, gap arthroplasty, and ipsilateral coronoidectomy...
March 2018: Journal of Craniofacial Surgery
Antonio Cortese, Mario Caggiano, Giuseppe Pantaleo, Massimo Amato, Pier P Claudio
BACKGROUND: Mandibular reconstruction after ablative surgery is challenging not only for the amount of bone tissue needed following bone loss after benign or malignant tumor surgical removal, but mainly to reconstruct bone shape and structure necessary for subsequent implant insertion to preserve the function (speech, swallowing and chewing) and aesthetic of the lower face. Several different techniques for maxillary bone defects reconstruction have been described. The aim of our work is to describe a new technique for mandibular reconstruction that uses an intramural distractor, which is placed in one surgical step and without the need for a skin incision...
February 9, 2018: Minerva Stomatologica
Zachary S Peacock, Alfonso Salcines, Maria J Troulis, Leonard B Kaban
PURPOSE: 1) To assess the fate of the permanent teeth in and adjacent to the regenerate in pediatric patients who underwent mandibular distraction osteogenesis (DO) and 2) to compare the postoperative growth of the distracted mandible with age- and gender-matched controls. PATIENTS AND METHODS: This was a retrospective cohort study of children who underwent mandibular DO during the primary or mixed dentition period and before completion of somatic growth (boys aged ≤14 years and girls aged ≤12 years) at Massachusetts General Hospital from 1996 to 2014...
January 31, 2018: Journal of Oral and Maxillofacial Surgery
Ling-Fei Ren, Geng-Sheng Shi, Yong-Qing Tong, Song-Yao Jiang, Feng Zhang
PURPOSE: The effects of a recombinant human bone morphogenetic protein-2/7 (rhBMP-2/7) heterodimer and a RADA16 (Ac-RADARADARADARADA-CONH2) hydrogel scaffold on bone formation during distraction osteogenesis were evaluated. MATERIALS AND METHODS: Forty New Zealand white rabbits, which underwent mandibular lengthening, were randomly divided into 5 groups. One group served as the control group. The others received 2 μg of rhBMP-2 homodimer, 2 μg of rhBMP-2/7 heterodimer, 100 μL of RADA16, or 100 μL of RADA16 plus 2 μg of rhBMP-2/7 heterodimer in the mandibular distraction gap at the beginning of distraction...
January 31, 2018: Journal of Oral and Maxillofacial Surgery
Jia Qiao, Bing Yu, Lai Gui, Xi Fu, Chung-Kwan Yen, Feng Niu, Huijun Zhang, Cai Wang, Ying Chen, Meng Wang, Jianfeng Liu
BACKGROUND: Interpositional arthroplasty (IPA) with temporalis fascia flap has been one of the most frequently performed procedures to treat temporomandibular joint (TMJ) ankylosis. However, recurrence often occurs when the flap lacks bulk or atrophies. Whether to perform IPA or distraction osteogenesis (DO) first has long been a controversial issue when patients presented mandibular dysplasia (MD). This study provided IPA a new graft material sufficient to prevent recurrence, combined the modified protocol of performing DO 6 months after IPA, and evaluated its efficacy in treating TMJ ankylosis patients with MD...
January 4, 2018: Journal of Craniofacial Surgery
Gagan Deep Kochar, Ashish Chakranarayan, Bensy Varghese, Sanjay Manohar Londhe, Sanjay Kumar Roy Chowdhury, Shreehari Ambika Krishnawarrier
Distraction osteogenesis has been a paradigm shift in the field of orthognathic surgery. Majority of the published cases are those of syndromic patients that have been managed using varying treatment protocols. This communication describes a patient of 18-year-old male diagnosed with skeletal Class II malocclusion due to mandibular retognathism. The patient was taken up for mandibular corpus distraction of 10 mm. By this approach the patient was benefitted with good esthetic result and functional occlusion...
March 2018: Journal of Craniofacial Surgery
Yeong Kon Jeong, Won-Jong Park, Il Kyung Park, Gi Tae Kim, Eun Joo Choi
Clinical limitations following closed reduction of an intracapsular condylar fracture include a decrease in maximum mouth opening, reduced range of mandibular movements such as protrusion/lateral excursion, and reduced occlusal stability. Anteromedial and inferior displacement of the medial condyle fragment by traction of the lateral pterygoid muscle can induce bone overgrowth due to distraction osteogenesis between the medial and lateral condylar fragments, causing structural changes in the condyle. In addition, when conventional maxillomandibular fixation (MMF) is performed, persistent interdental contact sustains masticatory muscle hyperactivity, leading to a decreased vertical dimension and premature contact of the posterior teeth...
October 2017: Journal of the Korean Association of Oral and Maxillofacial Surgeons
Navid Pourtaheri, Derek Z Wang, Srinivas M Susarla, Gerhard S Mundinger, Anand R Kumar
PURPOSE: To assess the two- and three-dimensional airway changes following unilateral vertical mandibular distraction osteogenesis (vMDO) in patients with hemifacial microsomia (HFM). METHODS: A retrospective evaluation was performed for consecutive patients over an 18-month period with HFM and with Kaban-Pruzansky Type-II mandibular deformities who underwent unilateral vMDO for correction of vertical mandibular asymmetry. Patients with complete records and a minimum of 12 months of clinical follow-up post-consolidation were included...
December 2017: Journal of Cranio-maxillo-facial Surgery
Hiroshi Tomonari, Hiroko Takada, Tomofumi Hamada, Sangho Kwon, Tsuyoshi Sugiura, Shouichi Miyawaki
BACKGROUND: We describe the case of a 16-year-old female patient with micrognathia, temporomandibular joint (TMJ) ankylosis, and obstructive sleep apnea, who was treated with mandibular distraction osteogenesis (DO) combined with sliding genioplasty, using skeletal anchorage. CASE PRESENTATION: We first performed interpositional arthroplasty, in which an interposition of fascia temporalis and surrounding fat tissue was inserted into the defect after bilateral condylectomy, increasing the maximum mouth opening from 5...
November 10, 2017: Head & Face Medicine
S M Balaji
Mandibular retrognathism is one of the important contributing anatomical factors to the obstructive sleep apnea (OSA). Such patients suffer from number of apneic or hypopneic events during sleep such as snoring, daytime sleepiness, fatigue, inability to concentrate, and irritability. Distraction osteogenesis is a less invasive surgical technique in the management of OSA by correcting the reduced airway space. Apart from correcting functional disturbances due to OSA, it also corrects the facial profile resulting in the substantial improvement in cosmetic appearance...
September 2017: Indian Journal of Dental Research: Official Publication of Indian Society for Dental Research
Patricia Stoor, Zlatan Hodzic, Sirpa Arte
The purpose of our retrospective study was to evaluate the results of orthognathic treatment, distraction osteogenesis, and/or prosthetic reconstruction of the temporomandibular joints in patients with juvenile idiopathic arthritis (JIA).Twelve patients with severely affected temporomandibular joints (TMJs) and reduced ramus height were treated with mandibular advancement with orthognathic surgery (11) and additional bilateral or unilateral mandibular ramus distraction (3) or additional bilateral or unilateral prosthetic reconstruction of the TMJ (3)...
January 2018: Journal of Craniofacial Surgery
Wai-Yee Li, Alana Poon, Douglas Courtemanche, Cynthia Verchere, Sandra Robertson, Marija Bucevska, Claudia Malic, Jugpal S Arneja
BACKGROUND: Pierre Robin sequence (PRS) is a triad of micrognathia, glossoptosis, and respiratory distress. There is no standard clinical classification used in the management of neonatal airway in patients with PRS. The goal of our study was to review the presentation and management of patients with PRS and formulate a clinical grading system and treatment algorithm. METHODS: A 10-year retrospective review of all neonates diagnosed with PRS was performed after obtaining institutional ethics approval...
February 2017: Plastic Surgery
Tao Li, Yi Man, Ruiye Bi, Nan Jiang, Yunfeng Li, Songsong Zhu
BACKGROUND: Distraction osteogenesis (DO) has become an important alternative for bone defect reconstruction. The study aims to investigate the clinical feasibility and efficiency of transport disc DO (TDDO) for reconstruction of segmental defect of mandible and further dental implant treatment. METHODS: A serial of 6 patients diagnosed with ameloblastoma or keratocystic odontogenic tumor were included in this study. Computed tomography (CT) scanning and panoramic radiograph were performed for preoperative evaluation and surgery planning...
November 2017: Journal of Craniofacial Surgery
Elizabeth G Zellner, Russell R Reid, Derek M Steinbacher
BACKGROUND: For Pierre Robin sequence (PRS) patients, there is incomplete characterization of 3D differences and effects of mandibular distraction osteogenesis (MDO) on the mandible compared to normal controls. METHODS: PRS infants who underwent MDO at 2 craniofacial referral centerals with pre- and postoperative computed tomography (CT) scans were identified. A group of age-matched control patients with CTs were identified in the PACS database. Demographic and perioperative data were recorded...
November 2017: Journal of Craniofacial Surgery
Anthony J Archual, Jonathan S Black
Craniofacial microsomia (CFM) is a common craniofacial anomaly characterized by asymmetric malformation of the mandible, ear, and other structures including the upper airway. The degree of mandibular hypoplasia is classified using a scheme developed by Pruzansky and modified by Kaban. Severe condylar dysplasia is the hallmark of Pruzansky-Kaban types IIB and III. Distraction osteogenesis has emerged as a treatment modality for mandibular hypoplasia in this setting for the treatment of asymmetry and airway obstruction...
November 2017: Journal of Craniofacial Surgery
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