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Distraction osteogenesis

Xi Lin, Nuo Zhou, Xuanping Huang, Shaohua Song, Hongyi Li
OBJECTIVE: This study is to present experiences of using anterior maxillary segmental distraction osteogenesis (AMSDO) with internal distractors for treatment of maxillary hypoplasia in patients with repaired cleft palate. MATERIALS AND METHODS: A total of 42 patients of maxillary hypoplasia with repaired cleft palate were included in this study, and underwent AMSDO. Cephalometric analysis and speech quality assessments were performed to evaluate the changes after AMSDO and its long-term effect on stability...
March 20, 2018: Journal of Craniofacial Surgery
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
Oswaldo Javir Gómez Díaz, Diana Carolina Martínez Gutiérrez, Luz Elena Rueda Gallardo
This article describes 2 patients with complex facial asymmetry characterized by hemiarhinia, microorbitism, palpebral fissure shortening, ipsilateral canthal dystopia, maxillomandibular hypoplasia, and occlusal plane inclination. These unusual phenotypes are part of the oculoauriculo-vertebral spectrum. Their devastating functional, esthetic, and psychologic effects demand the use of different craniofacial surgery techniques, in order to alleviate the profound impact of these pathologies. Initial skeletal balance through bimaxillary distraction osteogenesis and orbital expansion sets the basis for further reconstruction of the nose and periorbital area with local tissue...
March 16, 2018: Journal of Craniofacial Surgery
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
Frank Niemeyer, Lutz Claes, Anita Ignatius, Nicholaus Meyers, Ulrich Simon
Distraction osteogenesis is an effective method for generating large amounts of bone in situ for treating pathologies such as large bone defects or skeletal malformations, for instance leg-length discrepancies. While an optimized distraction procedure might have the potential to reduce the rate of complications significantly, our knowledge of the underlying mechanobiological processes is still insufficient for systematic optimization of treatment parameters such as distraction rate or fixation stiffness. We present a novel numerical model of lateral distraction osteogenesis, based on a mechanically well-controlled in vivo experiment...
2018: PloS One
Brian C Goh, Amit Jain, Paul D Sponseller
CASE: A 12-year-old girl with osteogenesis imperfecta (OI) underwent posterior spinal arthrodesis (from T2 to the sacrum) for double major-curve scoliosis. She developed complete paralysis of all of the extremities 24 hours after surgery, without evidence of ischemia or infarction. The rods were removed, and the neurologic status improved; there was full restoration of strength within 1 week. She then underwent in situ fixation. At the 2-year follow-up, there had been no lapse in neurologic function...
March 14, 2018: JBJS Case Connector
Mark Gage, Frank Liporace, Kenneth Egol, Toni McLaurin
Treatment of traumatic bone defects is dictated by a multitude of clinical factors including the defect size, patient comorbidities, soft tissue condition, and the possibility of infection present in the defect. With a variety of treatment strategies described, it is critical to choose the approach that will maximize outcomes in addressing this difficult problem. When addressing small-scale defects, bone grafting is the primary treatment. For large-scale defects, there are two major options to consider: induced membrane technique and distraction osteogenesis...
March 2018: Bulletin of the Hospital for Joint Diseases
Chihiro Tanikawa, Kae Hirata, Tomonao Aikawa, Jun Maeda, Mikihiko Kogo, Seiji Iida, Takashi Yamashiro
OBJECTIVES: To evaluate the effects of maxillary anterior segmental distraction osteogenesis (MASDO) in patients with cleft lip and palate (CLP) and to identify risk factors for increased relapse. DESIGN: A retrospective study. PATIENTS: Thirty-one Japanese patients with CLP who underwent MASDO were eligible for study inclusion. MAIN OUTCOME MEASURES: We evaluated lateral cephalograms obtained before (T1), at 3 months (T2), and at 1 year (T3) after MASDO, and measured changes from T1 to T2 (δT1T2), from T2 to T3 (δT2T3), and from T1 to T3 (δT1T3)...
January 1, 2018: Cleft Palate-craniofacial Journal
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
Netanja S Ter Maaten, Daniel M Mazzaferro, Ari M Wes, Sanjay Naran, Scott P Bartlett, Jesse A Taylor
BACKGROUND: Posterior vault distraction osteogenesis (PVDO) is believed to improve frontal contour in infants with syndromic craniosynostosis and turribrachycephaly. This study provides an objective craniometric analysis to determine how PVDO affects anterior cranial morphology. METHODS: A retrospective chart review of patients who underwent PVDO was performed. Inclusion criteria included pre- and postoperative computed tomography (CT) scans within 3 months before surgery and another 1 to 6 months after device removal...
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
Jian Song, Bin Ye, Hanghang Liu, Ruiye Bi, Nian Zhang, Jing Hu, En Luo
OBJECTIVES: To investigate the mechanism of mechanical stimulation in bone formation and regeneration during distraction osteogenesis. MATERIALS AND METHODS: In this study, microarray technology was used to investigate the time course of bone-related molecular changes in distraction osteogenesis in rats. Real-time PCR and Western-blot analyses were used to confirm the expression of genes identified in microarrays. Meanwhile, we used a lentivirus vector to inhibit Fak expression, in order to identify the osteogenic effect of Fak and Fak-Mapk pathway during distraction osteogenesis...
March 5, 2018: Cell Proliferation
Sayaka Mishima, Takako Yamaguchi, Takuma Watanabe, Toru Komatani, Kazumasa Nakao, Katsu Takahashi, Kazuhisa Bessho
It is known that congenitally missing teeth can often cause differences in craniofacial morphology; however, there are few reported cases of orthognathic surgical treatment for these patients. Herein, the authors report a rare case of maxillary hypoplasia with congenital oligodontia treated by maxillary distraction osteogenesis with internal device. A 17-year-old male presenting with multiple tooth agenesis and maxillary recession was referred to our hospital for orthognathic surgical treatment. Preoperative simulation surgery was performed using Full-Color 3-dimensional salt model...
February 27, 2018: Journal of Craniofacial Surgery
Michael G Brandel, Cecilia L Dalle Ore, Chris M Reid, Wendy W Zhang, William Zhu, Chinwe S Kpaduwa, Samuel Lance, Hal S Meltzer, Amanda A Gosman
INTRODUCTION: Methods of reporting quantitative results for distraction osteogenesis (DO) of craniosynostosis have been inconsistent. Therefore, the efficacy of differing techniques and timing in regard to volume change is not well established, with no uniform metric for comparisons. Given that cranial vault remodeling with DO may be completed with different approaches, analysis was made to determine (1) the relative efficiency of different approaches in expanding intracranial volume (ICV) and (2) the impact of adjusting for ICV growth on measured DO efficiency...
February 27, 2018: Annals of Plastic Surgery
Peter V Giannoudis, Christian Krettek, David W Lowenberg, Theodoros Tosounidis, Joseph Borrelli
Treatment of bone defects remains a challenging clinical problem. Despite our better understanding of bone repair mechanisms and advances made in microsurgical techniques and regenerative medicine, the reintervention rates and morbidity remain high. Surgical techniques such as allograft implantation, free vascularized fibular graft, distraction osteogenesis, loaded titanium cages, and the induced membrane technique continue to evolve, but the outcome can be affected by a number of parameters including the age of the patient, comorbidities, systemic disorders, the location of the defect, and the surgeon's preference and experience...
March 2018: Journal of Orthopaedic Trauma
Kai Liu, Nuo Zhou
PURPOSE: To systematically evaluate the skeletal changes after maxillary distraction osteogenesis (DO) in growing patients with cleft lip with or without cleft palate (CL/P). MATERIALS AND METHODS: Electronic databases, gray literature, and reference list searches were conducted. Articles reporting prospective and retrospective studies that included patients <16 years old (N ≥ 6) who had received DO surgery for correction of a midfacial hypoplasia due to CL/P, and the period of follow-up persisted >1 year were reviewed...
February 14, 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
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