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Distraction osteogenesis

Zi-Hui Yang, Bao-Lei Wu, Chen Ye, Sen Jia, Xin-Jie Yang, Rui Hou, De-Lin Lei, Lei Wang
Distraction osteogenesis (DO) is a widely used self-tissue engineering. However, complications and discomfort due to the long treatment period are still the bottleneck of DO. Novel strategies to accelerate bone formation in DO are still needed. P38 is capable of regulating the osteogenic differentiation of both mesenchymal stem cells (MSCs) and osteoblasts, which are crucial to bone regeneration. However, it is not clear whether targeting p38 could regulate bony formation in DO. The purpose of the current work was to investigate the effects of local application of either p38 agonist anisomycin or p38 inhibitor SB203580 in a rat model of DO...
2016: International Journal of Medical Sciences
Cenk Özkan, Mehmet Ali Deveci, Mustafa Tekin, Ömer Sunkar Biçer, Kadir Gökçe, Mahir Gülşen
OBJECTIVE: The present study assessed functional and radiographic outcomes of distraction osteogenesis treatment of post-traumatic elbow deformities in children. METHODS: Eight children were treated between 2008 and 2013 for post-traumatic elbow deformities using distraction osteogenesis. Mean age at time of operation was 10.9 years. Six patients had varus and 2 had valgus deformity. Magnitude of correction, fixator index, complications, carrying angle, and elbow range of motion were assessed...
October 17, 2016: Acta Orthopaedica et Traumatologica Turcica
Debraj Howlader, Dichen P Bhutia, U Vignesh, Divya Mehrotra
Facial asymmetry is one of the commonest facial anomalies, with reported incidence as high as 34%. Hemifacial microsomia (HFM) has an incidence of 1 in every 4000-5600 children and is one of the commonest causes of facial asymmetry. The standard treatment of HFM is orthognathic surgery by bilateral saggital split osteotomy (BSSO) or distraction osteogenesis (DO) of the mandible, both of which involve prolonged periods of occlusal adjustments by an orthodontist. Here, we present distraction of the mandible by means of a novel modified step osteotomy to correct the facial asymmetry in a case of hemifacial microsomia without disturbing the occlusion...
September 2016: Journal of Oral Biology and Craniofacial Research
Mustafa Sancar Ataç, Yeliz Kilinç
The bony augmentation of severely atrophied mandible is generally required for the purposes of prosthetic rehabilitations. The treatment strategies have been well defined in the literature ranging from osteotomy techniques to distraction osteogenesis. Visor osteotomy is the milestone of the reconstructive surgery for the atrophied mandible which has received some modifications. In the present study, the authors describe a new modification of visor osteotomy in which a complete coronal split osteotomy down to the inferior border at the mental region has been performed...
October 14, 2016: Journal of Craniofacial Surgery
Francesco Carlino, Gian Piero Villani, Andrea Berti, Giuseppe Pantaleo, Antonio Cortese, Pier Paolo Claudio
Aim of this work is to present the evolution of an innovative technique for tooth/implant supported bone distraction, leading to proper oral rehabilitation in patients with atrophic alveolar bone, even when a complete premaxilla expansion is needed, or in patients in whom implants were already present, but inserted in wrong position.Distraction osteogenesis was selected because of its moderate invasiveness, the few surgical steps needed, and the proper cost/benefits balance. This procedure is particularly suited for young patients with remarkable aesthetic demands related to active social and working life, as for elderly patients expecting lower surgical stress and risks...
October 14, 2016: Journal of Craniofacial Surgery
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
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
Dong Ha Park, Soo Han Yoon
OBJECTIVE: Among shunt complications, the post-shunt slit ventricle (PSSV) and the post-shunt craniosynostosis (PSCS) may be managed by shunt valve upgrade and/or cranial expansion surgery. Here, we analyzed 26 children with PSSV and/or PSCS who received simple generalized cranial expansion, i.e., total calvarial trans-sutural distraction osteogenesis (TC-TSuDO). METHODS: Among 254 children with shunt surgery, 26 children received TC-TSuDO. These 26 children included of 14 with PSSV, 4 with PSCS, and 8 with both PSSV and PSCS...
October 3, 2016: World Neurosurgery
Lisa M Morris
This article provides an overview of etiology, epidemiology, pathology, diagnosis, and treatment of nonsyndromic craniosynostosis, including sagittal, metopic, coronal, lambdoid, and complex synostosis. Detailed discussion is presented regarding indications for surgical intervention and management options, including frontoorbital advancement, cranial vault reconstruction, endoscopic strip craniectomy, spring-assisted strip craniectomy, and cranial vault distraction osteogenesis. Deformational plagiocephaly is also presented with treatment options including repositioning, physical therapy, and helmet therapy...
November 2016: Facial Plastic Surgery Clinics of North America
R Rohilla, J Wadhwani, A Devgan, R Singh, M Khanna
AIMS: This is a prospective randomised study which compares the radiological and functional outcomes of ring and rail fixators in patients with an infected gap (> 3 cm) nonunion of the tibia. PATIENTS AND METHODS: Between May 2008 and February 2013, 70 patients were treated at our Institute for a posttraumatic osseocutaneous defect of the tibia measuring at least 3 cm. These were randomised into two groups of 35 patients using the lottery method. Group I patients were treated with a ring fixator and group II patients with a rail fixator...
October 2016: Bone & Joint Journal
Esperanza Macarena López-Pliego, Miguel Ángel Giráldez-Sánchez, Juan Mora-Macías, Esther Reina-Romo, Jaime Domínguez
INTRODUCTION: Bone transport (BT) for segmentary bone defects is a well-known technique as it enables correction with new bone formation, which is similar to the previous bone. Despite the high number of experimental studies of distraction osteogenesis in bone lengthening, the types of ossification and histological changes that occur in the regenerate of the bone transport process remain controversial. OBJECTIVE: The aim of this study is to provide the complete evolution of tissues and the types of ossification in the regenerate during the different phases of bone formation after BT until the end of the remodelling period...
September 2016: Injury
Dimitrios Kloukos, Piotr Fudalej, Patrick Sequeira-Byron, Christos Katsaros
BACKGROUND: Cleft lip and palate is one of the most common birth defects and can cause difficulties with feeding, speech and hearing, as well as psychosocial problems. Treatment of orofacial clefts is prolonged; it typically commences after birth and lasts until the child reaches adulthood or even into adulthood. Residual deformities, functional disturbances, or both, are frequently seen in adults with a repaired cleft. Conventional orthognathic surgery, such as Le Fort I osteotomy, is often performed for the correction of maxillary hypoplasia...
September 30, 2016: Cochrane Database of Systematic Reviews
Ibrahim Elsayed Abdellatif Abuomira, Francesco Sala, Yasser Elbatrawy, Giovanni Lovisetti, Salvatore Alati, Dario Capitani
This retrospective review assesses 55 tibial nonunions with bone loss to compare union achieved with combined Ilizarov and Taylor spatial frames (I-TSF) versus a conventional circular frame with the standard Ilizarov procedure. Seventeen (31 %) of the 55 nonunions were infected. Thirty patients treated with I-TSF were compared with 25 patients treated with a conventional circular frame. In the I-TSF group, an average of 7.6 cm of bone was resected and the lengthening index (treatment time in months divided by lengthening amount in centimeters) was 1...
September 22, 2016: Strategies in Trauma and Limb Reconstruction
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
Roman H Khonsari, Benjamin Way, Johan Nysjö, Guillaume A Odri, Raphaël Olszewski, Robert D Evans, David J Dunaway, Ingela Nyström, Jonathan A Britto
A major concern in FGFR2 craniofaciosynostosis is oculo-orbital disproportion, such that orbital malformation provides poor accommodation and support for the orbital contents and peri-orbita, leading to insufficient eyelid closure, corneal exposure and eventually to functional visual impairment. Fronto-facial monobloc osteotomy followed by distraction osteogenesis aims to correct midfacial growth deficiencies in Crouzon-Pfeiffer syndrome patients. Fronto-facial bipartition osteotomy followed by distraction is a procedure of choice in Apert syndrome patients...
August 21, 2016: Journal of Cranio-maxillo-facial Surgery
Ge Ma, Jin-Long Zhao, Ming Mao, Jie Chen, Zhi-Wei Dong, Yan-Pu Liu
PURPOSE: Stem cell therapy is becoming a potent strategy to shorten the consolidation time and reduce potential complications during distraction osteogenesis (DO). However, the conventional local injection or scaffold-based delivery of bone marrow mesenchymal stem cell (BMSC) suspension deprives the cells of their endogenous extracellular matrix, which might dampen cell differentiation and tissue regeneration after implantation. Therefore, in our study, a BMSC sheet was established and was then minced into fragments and loaded onto a hydroxyapatite (HA) scaffold for grafting...
August 24, 2016: Journal of Oral and Maxillofacial Surgery
Neha Neha, Tulika Tripathi, Sujata Mohanty, Priyank Rai
Because of the high failure rates, large alveolar cleft defects cannot be successfully closed with bone grafting. Vega introduced the use of the hyrax screw for the closure of such defects by distraction osteogenesis. However, his technique was more invasive with a difficult adaptation of the appliance at the surgical table. To overcome these limitations, a completely tooth-borne trifocal distraction appliance was devised and placed after osteotomy in a 22-year-old repaired group 3 cleft patient who had a 15-mm alveolar defect on the right side...
September 16, 2016: Cleft Palate-craniofacial Journal
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
Jia Xu, Bin Wang, Yuxin Sun, Tianyi Wu, Yang Liu, Jinfang Zhang, Wayne Yukwai Lee, Xiaohua Pan, Yimin Chai, Gang Li
BACKGROUND: Distraction osteogenesis (DO) is one of the most dramatic reconstructive techniques for inducing bone regeneration, but it involves an undesirably long period for bone consolidation. Developing innovative approaches to enhance bone consolidation is a burning need. Human fetal mesenchymal stem cells (hFMSCs) have been shown to express more primitive developmental genes than those of human adult mesenchymal stem cells (hAMSCs), which is a preferable source for cell therapy and tissue regeneration...
2016: Stem Cell Research & Therapy
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
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