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Mandibular distraction

Paola Papoff, Marco Castori, Lucia Manganaro, Fabio Midulla, Corrado Moretti, Piero Cascone
Although micrognathia and cleft palate have been reported in patients with Lymphedema-distichiasis syndrome (LDS), the classic Robin sequence with glossoptosis and airway obstruction has not been previously described in patients with genetically confirmed LDS. Here we report on two female siblings with LDS confirmed by a FOXC2 mutation who presented at birth with severe airway obstruction related to Robin sequence. Respiratory obstruction was successfully managed by early distraction osteogenesis. Our report highlights the unusual occurrence of Robin sequence in LDS patients and advises distraction osteogenesis to resolve breathing problems in LDS patients who present with Robin related severe airway obstruction...
September 2016: Journal of Maxillofacial and Oral Surgery
Hideyuki Suenaga, Asako Taniguchi, Kazumichi Yonenaga, Kazuto Hoshi, Tsuyoshi Takato
INTRODUCTION: Computer-assisted preoperative simulation surgery is employed to plan and interact with the 3D images during the orthognathic procedure. It is useful for positioning and fixation of maxilla by a plate. We report a case of maxillary retrusion by a bilateral cleft lip and palate, in which a 2-stage orthognathic procedure (maxillary advancement by distraction technique and mandibular setback surgery) was performed following a computer-assisted preoperative simulation planning to achieve the positioning and fixation of the plate...
October 4, 2016: International Journal of Surgery Case Reports
Zi-Chao Zhou, Lei Che, Liang Kong, De-Lin Lei, Rui Liu, Xin-Jie Yang
OBJECTIVE: This study investigated the effects and possible molecular mechanism of casein kinase-2 interacting protein-1 (CKIP-1) silencing on bone regeneration during rat mandibular distraction osteogenesis (DO). STUDY DESIGN: CKIP-1 silencing by chitosan/si-CKIP-1 was employed and analyzed both in rat mandibular DO models in vivo and in cultured rat mandible bone marrow stromal cells (BMSCs) in vitro. RESULTS: Gross observation, micro-computed tomography analysis, and hematoxylin and eosin (H&E) staining revealed that new bone formation in the distraction gap of the chitosan/si-CKIP-treated group was better compared with the chitosan/si-NC and phosphate buffered saline-treated groups in both quantity and quality...
July 30, 2016: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Elizabeth G Zellner, Julie M Mhlaba, Russell R Reid, Derek Steinbacher
PURPOSE: The goal of mandibular distraction in the Pierre-Robin sequence is to maximally expand the oropharyngeal airway. It has been hypothesized that a steep oblique distraction vector might allow greater airway enlargement compared with horizontal distraction. This study compared vector orientation in relation to airway volume and overall clinical outcome. MATERIALS AND METHODS: Micrognathic infants who underwent mandibular distraction with sufficient computed tomographic data were retrospectively reviewed...
September 13, 2016: Journal of Oral and Maxillofacial Surgery
Baolei Wu, Lei Wang, Xi Yang, Ming Mao, Chen Ye, Peng Liu, Zihui Yang, Xinjie Yang, Delin Lei, Chenping Zhang
Mesenchymal stem cells (MSCs), which are physiologically maintained in vascular endothelial cell (VEC)-based niches, play a critical role in tissue regeneration. Our previous studies demonstrated that sympathetic denervation could promote MSC mobilization, thereby enhancing bone formation in distraction osteogenesis (DO), a self-tissue engineering for craniofacial and orthopeadic surgeries. However, the mechanisms on how sympathetic neurotransmitter norepinephrine (NE) regulates MSC migration are not well understood...
September 17, 2016: Experimental Cell Research
Hanneke Basart, Hedy A van Oers, Emma C Paes, Corstiaan C Breugem, J Peter W Don Griot, Chantal M A M van der Horst, Lotte Haverman, Raoul C Hennekam
This patient-reported outcome (PRO) study reports on 102 children with Robin sequence (RS) and their parents. There has been differentiated between those with isolated RS and those with RS as part of a syndrome, and take various treatments into account. All RS families from an earlier described cohort were invited to participate. Parents and RS children completed online questionnaires regarding health-related quality of life (HRQoL), satisfaction with appearance, parental distress, and RS specific topics. Results were compared with the Dutch norm population if available...
September 20, 2016: American Journal of Medical Genetics. Part A
J N Bangiyev, H Traboulsi, I Abdulhamid, A Rozzelle, P J Thottam
INTRODUCTION: Pierre-Robin Sequence (PRS), a triad of micro/retrognathia, glossoptosis, and upper airway obstruction, usually in conjunction with a cleft palate is frequently associated with significant morbidity. Mandibular distraction osteogenesis (MDO) is an effective treatment modality to address retroglossal upper airway obstruction by increasing the anterior-posterior diameter of the infant airway. Although MDO has been shown to improve the apnea-hypopnea index (AHI) in children with PRS, the consequences of MDO on other aspects of infant sleep, including hypercapnea, hypoxia, the REM to Non-REM ratio, as well as its effect on central and mixed apneas has not been investigated with an adequate sample size...
October 2016: International Journal of Pediatric Otorhinolaryngology
Arman T Serebrakian, Michael S Golinko, Michael Alperovich, Christopher M Runyan, David A Staffenberg
Craniofacial microsomia remains the second most common craniofacial deformity after cleft lip and palate. Mandibular pathology has been classically scored from type I to type III by the modified Pruzansky-Kaban classification. The authors report a case of a 5-year-old patient with Goldenhar syndrome and bilateral type III craniofacial macrosomia. The patient had absence of bilateral glenoid fossas, condyles, coronoids, and rami as well as hypoplasia of the symphysis, parasymphysis, and mandibular body. Reconstruction was performed using 2 costochondral rib autografts to reconstruct a ramus and assist in the development of a neo-glenoid fossa at the cranial base...
October 2016: Journal of Craniofacial Surgery
J P de Gijt, A Gül, H Sutedja, E B Wolvius, K G H van der Wal, M J Koudstaal
To assess the long-term stability and biomechanical effects of mandibular midline distraction (MMD), a prospective observational study was conducted with a retrospective cohort. Included were 17 MMD patients, of whom 9 completed the long-term follow-up with a mean of 6.5 years. In all patients, a bone-borne distractor was used. Dental casts and postero-anterior (PA) cephalograms were taken at fixed time points: pre-operative (T1), directly post-distraction (T2), 1-year post-operative (T3) and long-term follow-up (T4)...
July 14, 2016: Journal of Cranio-maxillo-facial Surgery
G Rossini, B Vinci, R Rizzo, T M DaC Pinho, A Deregibus
Mandibular distraction osteogenesis (MDO) has been widely adopted in modern maxillofacial surgery due to its less invasive approach and the consistent aesthetic and functional improvements obtained. The aim of the present systematic review was to analyze the available evidence on the skeletal and soft tissue effects of MDO. The medical literature was searched to identify all peer-reviewed papers meeting the selection criteria for the final review process. A three-point grading system was used to rate the methodological quality of the selected papers...
November 2016: International Journal of Oral and Maxillofacial Surgery
Franco Carlino, Giuseppe Pantaleo, Fabio Ciuffolo, Pier Paolo Claudio, Antonio Cortese
INTRODUCTION: A surgical technique to widen the mandible is the mandibular midline distraction: the most common indications for mandibular midline distraction are severe mandibular anterior crowding, severe mandibular transverse deficiency, uni- or bilateral crossbite, impacted anterior teeth with inadequate space, and tipped teeth. Commonly used distraction devices can be divided into 2 systems: bone-borne distraction system appliance, dental-borne distraction systems. Each system has peculiar advantages, disadvantages, and different indications...
September 2016: Journal of Craniofacial Surgery
Wai Kin Tsui, Yanqi Yang, Lim Kwong Cheung, Yiu Yan Leung
BACKGROUND: To conduct a systematic review to answer the clinical question "What are the effectiveness of mandibular distraction osteogenesis (MDO) and its complications to treat patients with obstructive sleep apnea syndrome (OSAS)?". METHODS: A systematic search including a computer search with specific keywords, reference list search, and manual search were done. Relevant articles on MDO were assessed and selected in 3 rounds for final review based on 5 predefined inclusion criteria and followed by a round of critical appraisal...
September 2016: Medicine (Baltimore)
Akmam H Al-Mahdi, Sarah N Al-Hasnawi, Hassanien A Al-Jumaily
BACKGROUND: Mandibular distraction osteogenesis is the process of generating new bone in a gap between 2 bone segments in response to the application of graduated tensile stress across the bone gap. These distraction forces applied to bone also create tension in the surrounding soft tissues resulting in simultaneous expansion of the functional soft tissue matrix. AIM: To investigate and evaluate the changes in facial soft tissue following mandibular distraction osteogenesis and their relationship with the changes in bone movements...
October 2016: Journal of Craniofacial Surgery
Pushkar Gadre, Divya Singh, Kiran Gadre, Imran Khan
Osteoid osteoma, a rare benign osteoblastic tumor first described by Jaffe in 1935, is characterized as a small but painful lesion that mostly affects younger people. Usually benign and harmless, osteomas are removed for pain or esthetic reasons.Piezoelectric surgery is also increasingly being used effectively in major and minor osseous oral and maxillofacial surgeries, in delicate areas. It is used regularly for various procedures, including sinus lift procedures, bone graft harvesting, osteogenic distraction, ridge expansion, inferior alveolar nerve decompression and lateralization, cyst removal, dental extraction, and impacted tooth removal...
October 2016: Journal of Craniofacial Surgery
Girish B Giraddi, Kirti Arora, A J Sai Anusha
AIMS: The aims of the study were to evaluate the efficacy of simultaneous interpositional arthroplasty with distraction osteogenesis (DO) as a single procedure and to give the patient acceptable functional rehabilitation with correction of the gross facial asymmetry. MATERIALS AND METHODS: Nine patients of temporomandibular joint (TMJ) ankylosis with micrognathia were treated with interpositional arthroplasty and simultaneous DO and followed for a period of minimum 3 years...
January 2016: Annals of Maxillofacial Surgery
A Gallucci, N Graillon, J M Foletti, C Chossegros, F Cheynet
Congenital deformities of the mandibular ramus and of the temporo-mandibular joint are treated by surgery since the early 20th century. However, morphological and functional results are often disappointing, accounting for iterative operations. Today, a clear consensus concerning the type of intervention to be proposed, and at what age it should be carried out does not yet exist. For mild cases, "conventional" orthognathic or osteogenic distraction procedures seem to work well, especially if they are carried out at the end of growth...
September 2016: Revue de Stomatologie, de Chirurgie Maxillo-faciale et de Chirurgie Orale
Alex Viezel-Mathieu, Tyler Safran, Mirko S Gilardino
BACKGROUND: Tongue-lip adhesion (TLA) involves surgically tethering the tongue forward to the lower lip and is a technique to relieve airway obstruction caused by glossoptosis and retrognathia. The purpose of the present study was to evaluate the effectiveness of TLA for the treatment of airway compromise in patients with Pierre Robin sequence (PRS). METHODS: A comprehensive literature review was performed. Inclusion criteria consisted of patients having undergone isolated tongue lip adhesion and results that included airway outcome...
September 2016: Journal of Craniofacial Surgery
Angelo Luiz Freddo, Caroline Comis Giongo, Deise Ponzoni, Adriana Corsetti, Edela Puricelli
PURPOSE: This study evaluated the use of low-level laser therapy (LLLT) and exposure to a magnetic field (MF) during distraction osteogenesis. MATERIALS AND METHODS: The sample consisted of 18 rabbits divided into 3 groups of 6 animals each: control, MF exposure (briefly, magnetized gold-coated washers were placed next to the distractor device), and LLLT exposure (830 nm applied every 48 hours over 4 points [dose, 5 J/cm(2)] during the consolidation period). The same distraction osteogenesis protocol was used in all 3 groups (0...
July 25, 2016: Journal of Oral and Maxillofacial Surgery
Ashim N Adhikari, Andrew A C Heggie, Jocelyn M Shand, Patrishia Bordbar, Anastasia Pellicano, Nicky Kilpatrick
BACKGROUND: Mandibular distraction osteogenesis (MDO) is an effective method of treating upper airway obstruction (UAO) in micrognathic infants. The short-term outcomes include relief of UAO, avoidance of tracheostomy, and prompt discharge from hospital. However, it is a significant surgical procedure with potential associated morbidities. This study describes a cohort of infants managed using MDO over a twelve-year period. METHODS: A retrospective chart review was undertaken for children who had MDO before the age of 5 years between 2000 and 2012...
July 2016: Plastic and Reconstructive Surgery. Global Open
P Guerreschi, A Wolber, Y Bennis, M Vinchon, V Martinot-Duquennoy
Distraction osteogenesis, initially developed by Ilizarov for limb, is the tissular extension caused by the progressive space of the osseous pieces following an osteotomy. Distraction is osteogenesic and histogenic. Twenty-five years ago, at the instigation of McCarthy, this technique was used to handle the craniofacial malformations in the various floors of the face : mandibular, mediofacial and cranial. The most wide-spread protocols respect a latency period from 0 to 7 days, a rhythm of distraction from 1 to 2mm a day in 2 at 4 times and a period of consolidation from 4 to 8 weeks...
October 2016: Annales de Chirurgie Plastique et Esthétique
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