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At least 433 records · Page 24Linked to original sources
PubMed2001

[Distraction osteogenesis in correction of mandibular micrognathia accompanying obstructive sleep apnea syndrome].

OBJECTIVE: To evaluate the effect of distraction osteogenesis in correction of mandibular micrognathia accompanying obstructive sleep apnea syndrome (OSAS). METHODS: A total of 15 patients, aged 9 to 43 years, 11 males and 4 females, were treated. 7 patients suffered from bilateral ankylosis of temporo manclibular joint inducing severe mandibular micrognathia and accompanying severe OSAS. 3 cases suffered from unilateral TMJ ankylosis with OSAS. 3 patients suffered from congenital developmental micrognathia with OSAS. 2 cases were caused by trauma. Among the 15 patients, 12 were treated by synchronous bilateral mandibular distraction, 3 patients were distracted unilaterally. Every patient had been evaluated pre- and postoperatively with cephalometry and polysomnography. RESULTS: The minimum distance of distraction was 9 mm, the maximum was 30 mm, with a mean of 20.4 mm, in mandible of 15 patients with 27 sides. The distraction process was smooth in all the cases. The osteogenesis was good, without infection and other complications. Complete curative effect was achieved in 4 severe, 3 moderate, and 4 mild cases. The posterior airway space was increased from averaged 4.5 mm preoperatively to 12.4 mm. The increase of SNB angle was from preoperative 66 degrees to 75 degrees on average postoperatively. The vast majority of the patients had their subjective symptoms alleviated gradually or disappeared completely. The results were stable without relapse during a follow-up period of 12 months. CONCLUSION: The distraction osteogenesis can not only be used to effectively correct severe mandibular micrognathia deformity, but also can cure its accompanying OSAS. The procedure is simple, with low risk, high curative rate, low relapse rate, and stable result. Up to now, it is the most effective method in the treatment of this difficult and complicated kind of disorder.

Adolescent↗
PubMed2000

[Distraction osteogenesis for correction of maxillary constriction].

OBJECTIVE: To study the methods and effects of distraction osteogenesis for correction of maxillary constriction. METHODS: 10 cases (5 males, and 5 females, aged 16-33 years, average 19.6) were treated by distraction osteogenesis for correction of maxillary constriction. Le Fort I osteotomy and palatal suture osteotomy for the upper jaw were made before opening of the Hyrax screw expander. Totally four times of opening the screw a day were performed. 2 cases were expanded unilaterally. The AP head films were analyzed using Image and Database Analysis System (IDAS) before and after expansion. RESULTS: 1. Expansion of upper arch was achieved done within a few days, and the maxilla, maxillary dental base and the posterior teeth were expanded as much as 3.84 mm, 3.25 mm, and 5.61 mm respectively. 2. The new bone was formed between the opened suture in two weeks, and filled the suture in 2 to 3 months. 3. Maxillary teeth tipped bucally a little bit. CONCLUSIONS: Distraction osteogenesis rapid maxillary expansion could get a good result following Le Fort I and palatal suture osteotomy for correction of maxillary constriction.

Adolescent↗
PubMed2000

[Application of distraction osteogenesis in functional mandibular reconstruction].

OBJECTIVE: To study the application of distraction osteogenesis in mandibular functional reconstruction. METHODS: Three kinds of mandibular distractors were used in 6 cases who had different mandibular defects because of tumor resection. For two cases with defect of most part of ramus specially desinged distractors were used in order to keep the normal height of the ramus. In one case the trifoci distraction principles were used and a trifoci distractor was desinged. In three cases the vertical distractors made in Germany or China respectively were used. The average age of 6 patients was 31.5 years old (from 8 to 54). RESULTS: The mandibular lengthenings in 5 cases were fully successful according to the direction and distance desinged before distraction. In one case the trifoci distraction principle was applied and a proximal 23 mm mandibular defect was corrected successfully, however, the 23 mm distal mandibular defect had not corrected because the screws for fixation of the transport block was loosened. No infection and dysosteogenesis were happened in all cases. CONCLUSIONS: Distraction osteogenesis can successfully be used in mandibular functional reconstruction and has much more advantages than traditional techniques. The most favorable time for distraction osteogenesis in mandibular reconstruction is at the same stage of tumor resection.

Adolescent↗
PubMed2001

Alveolar ridge widening by distraction osteogenesis: a case report.

Alveolar width deficiencies have generally been corrected by guided tissue regeneration or bone augmentation with and without membranes. The use of distraction osteogenesis is proposed for the correction of horizontal alveolar width defects. In this case report, horizontal bone generation by distraction osteogenesis was achieved prior to implant placement. Following implant restoration, favorable bone response was observed after two years of function. Distraction osteogenesis to widen the alveolus may prove to be a clinically useful treatment option in selected cases.

Alveolar Ridge Augmentation↗
PubMed2000

[Management of micrognathia deformity associated with obstructive sleep apnea syndrome by distraction osteogenesis].

OBJECTIVE: To review the early results of lengthening of the mandible by distraction osteogenesis for the correction of micrognathia deformity and treatment of the obstructive sleep apnea syndrome (OSAS) simultaneously. METHODS: 5 cases with micrognathia deformity associated with OSAS resulted from unilateral/bilateral temporomandibular joint ankylosis had undergone mandibular distraction osteogenesis. In all of the patients intraoral device was employed. Cephalometric radiographs and polysomnograms were obtained preoperatively and postoperatively. RESULTS: The average distraction distance was 15.28 mm (range 8.5 mm to 24.4 mm). The micrognathia deformity was corrected effectively, at the mean time the incapacious pharyngeal airway was ameliorated. The patients' Apnea Index (AI) had been decreasing, SaO(2) during sleep had got to rise. CONCLUSIONS: Compared with the traditional surgery for the micrognathia associated with OSAS, the technique of mandibular distraction osteogenesis has the advantages of avoiding bone grafting and donor side morbidity, expanding the surrounding soft tissue concurrently, reducing the extent of operation and stability of the treatment effects.

Adolescent↗
PubMedDate not supplied

Alveolar distraction osteogenesis: a case report involving ankylosed maxillary central incisors.

Restorative dentistry, for the optimal esthetic and functional result, at times requires innovation, exacting techniques, and employment of various treatment modalities. A case has been presented here involving a large esthetic defect in the maxillary anterior. Traditional methods of restoration may have been successful but alveolar distraction osteogenesis was determined to be the treatment of choice due to time, predictability, lack of invasiveness, and cost. It is a relatively new surgical procedure that has many applications to restore esthetic defects, ridge augmentation, and large craniofacial abnormalities. Movement of osseous sections can be made in a vertical, labial, or lingual direction. When treatment planning restorative dentistry with vertical hard and soft tissue deficiencies, alveolar distraction osteogenesis can be considered to achieve optimal esthetics and a more ideal crown-to-root ratio. Further information can be obtained from any oral surgeon, orthodontist, or from the Internet. Dr. Martin Chin, a maxillofacial surgeon from San Francisco, has done much of the clinical work regarding distraction procedures on humans and continues to be an innovator in craniofacial distraction osteogenesis. His work can be found on the Internet at www.distraction.net; other interesting Web sites include www.klsmartin.com/distract.dir/indexdistract.html and www.seattle-implants.com/articles/distost.htm.

Adolescent↗
PubMed1999

[Experimental study and clinical application on osteogenesis of percutaneous autogenous bone marrow grafting in bone defects].

OBJECTIVE: To observe the osteogenesis of percutaneous autogenous bone marrow grafting in cicatricial bone defect, to seek a good method for treating fracture nonunion. METHODS: Eighteen rabbits were adopted in this study. 1 cm bone defect model was made in each side of radius, 6 weeks later, 2 ml autogenous bone marrow was injected in the right radial bone defect as experimental group, 2 ml autogenous peripheral blood in the left side as control group. X-ray features, histologic changes, Ca and P content in the site of bone defect were studied in various times. Also 15 patients were treated clinically for the nonunion fracture, the average time from nonunion to bone marrow grafting was 13 months. RESULTS: In experimental group, the increasing new bone tissue were observed in X-ray and histologic examination. While in control group, no osteogenesis was observed. Ca and P content of experimental group was higher than that of control group. For the 15 patients, 13 cases healed in 5-9 months, 2 cases failed. CONCLUSION: Percutaneous autogenous bone marrow grafting is capable of osteogenesis in the cicatricial bone defects. It can be used in nonunion cases which are not fit for operation of bone grafting because of poor condition of the skin.

Adolescent↗
PubMed2002

[Application of distraction osteogenesis in severe maxillary hypoplasia secondary to cleft palate].

OBJECTIVE: To evaluate the effect of distraction osteogenesis in correction of severe undeveloped maxilla secondary to cleft palate and to evaluate the selection of distraction modality. METHODS: Distraction osteogenesis was performed upon 8 patients, 6 males and 2 females, aged 11 to 25 years, one with incomplete cleft palate, 4 with unilateral complete left palate, and 3 with bilateral complete cleft palate, all accompanied with severe maxillary hypoplasia. The 7 adult patients were treated by modified high-stepped Le Fort I osteotomy, the other patient, a child, was treated by Le Fort I osteotomy followed by rigid external distraction. X-ray films of skull in lateral, frontal, or panoramic positions, and X-ray film of temporomandibular joint in Schiller's position were taken pre- and postoperatively. In model surgery the accurate distraction distance was measured and the direction of distraction designed. Orthodontic therapy was started immediately after the distraction was completed and the distractor was removed after a period of 4 months' consolidation. RESULTS: The designed distraction was achieved in a11 8 patients. Except in one case with a bone defect 1 cm x 0.5 cm at the osteotomy line in the lateral wall of the right maxillary sinus, dense new bone was formed in the area of distraction in the other cases. The postoperative occlusal relationship was good and stable. No infection and other complication was found. During an average of 20 months' follow-up, the maxilla and occlusion were stable, and no relapse was found. The distance of forward distraction of the maxilla reached an average of l2 mm (5 approximately 15 mm). The SNA angle increased from 71 degree on average preoperatively to an average of 79 degree postoperatively. Both the facial appearance and occlusal relationship returned to normal in a11 the patients. CONCLUSION: Without need of bone grafting and with a stable effect and little influence on platatopharyngeal competence, distraction osteogenesis is an effective method of correcting maxillary hypoplasia secondary to cleft palate and is worthy of spreading.

Adolescent↗
PubMed2002

[Results of stapedectomy in osteogenesis imperfecta].

Osteogenesis imperfecta is a connective tissue disease connected with improper synthesis of collagen type I. Bone fragility, blue sclera and hearing loss are the main symptoms of classic type of the disease. Early (6 months) and late (10 years) results of stapedectomy in 3 patients with osteogenesis imperfecta syndrome are presented. Six months postoperatively air-bone gap was smaller than 10 dB in 2 patients and 17 dB in one patient. In all patients, bone conduction pure tone threshold improved after the operation. Audiometric tests performed 10 years after stapedectomy were similar to those obtained 6 months after the operation. Stapedectomy in patients with osteogenesis imperfecta syndrome provides good and stable hearing results.

Adult↗
PubMed2002

Mandibular functional reconstruction using internal distraction osteogenesis.

OBJECTIVE: To study the potential and advantages of internal distraction osteogenesis in mandibular functional reconstruction. METHODS: Three types of mandibular distractors were used in eight patients with various mandibular defects due to tumor or cyst resection. The average age of the patients was 31.5 years old (ages ranged from 8 to 54 years). For two patients with ramus defects, specially designed distractors were used to restore the normal ramus height. In two other patients, specially designed trifocal distractors were used. In three patients, vertical distractors were used. RESULTS: All the mandibles were successfully reconstructed in accordance with the direction and distance designed before operation except in one patient. In that patient the distal 23 mm defect failed to be corrected because of loosening of transport block fixation screws. CONCLUSIONS: Mandibular defects can be successfully corrected using internal distraction osteogenesis. Performing mandibular reconstruction using distraction osteogenesis is best done at the time of tumor or cyst resection.

Adult↗
PubMed2003

[The influence of the osteogenesis in cleft palate after palatal surgery to the transverse growth of dental occlusion].

OBJECTIVE: To compare the transverse growth of the dental cast following palatal surgery with or without osteogenesis in palatal gap. METHODS: 31 patients at 13 - 28 years old with repaired palate were selected to take the dental cast, the width of the dental arch, alveolar base and the matching degree between arches were measured and the average was calculated. After the length of the bone bridge in palate was measured through CT scan, the relationship between the osteogenesis in palatal gap and the transfers growth of dental cast was studied. RESULTS: The critical length of the bone regeneration in palatal gap to affect the dental growth is 4 mm, mean while the sufficient length is 8 mm. The group of sufficient bone bridge has a better development in both the width of dental alveolar base and that of dental arch and the matching degree than the group of unsurficience. And this intendance was more obvious in premolar region than in molar region. CONCLUSIONS: The osteogenesis in palatal gap following palatal surgery can strongly support the transfers growth in the width of dental arch, the width of alveolar base and the matching degree between upper and lower dental arch.

Adolescent↗
PubMed2002

[The child with osteogenesis imperfecta. Care plans].

The authors state what is the nursing care to follow with a child affected by imperfect osteogenesis. This treatment is divided into three fundamental parts. In the first part, one plans out the psycho-sociological assistance the parents in question need in order to achieve their acceptance of a child suffering from a serious illness. In the second part, the authors describe the physical and psychological treatment which patients suffering imperfect osteogenesis should receive in order to avoid serious complications which can develop during their growth, treatment directed towards the family and the professional who shall care for this child. Finally in the third part, a child suffering imperfect osteogenesis shall receive the necessary knowledge and skills so that he/she can achieve maximum social integration.

Child↗
PubMed2003

[Research in use of vascular endothelial cells to promote osteogenesis of marrow stromal cells].

Osteogenesis deep in the materials is postponed because the blood vessels grow into the materials very slowly. It is one of the key challenges to the bone tissue engineering researchers. However, it was found that marrow stromal cells can produce vascular endothelial growth factor (VEGF) while endothelial cells produce bone morphogenetic protein (BMP). So we presume if we have co-culture of marrow stromal cells and endothelial cells on the biomaterials, osteogenesis and angiogenesis may be promoted simultaneously. In this experiment, we compare the alkaline phosphatase (ALP) activity and osteocalcin (OCN) production of three groups: the marrow stromal cells under activation of endothelial cells culture fluid, the induced marrow stromal cells, and the untreated marrow stromal cells. The results reveal that the ALP activity and OCN production of the marrow stromal cells under activation of endothelial cell culture fluid and the ALP activity and OCN production of the induced marrow stromal cells do not show statistically significant difference, but they are significantly higher than those of the untreated marrow stromal cells (P < 0.01). It is concluded that the VEGF in the endothelial cell culture fluid can promote osteogenesis as effective as osteogenic induction medium can do.

Alkaline Phosphatase↗
PubMed1992

[The radiology of osteogenesis imperfecta].

The term "osteogenesis imperfecta" refers to a heterogeneous group of hereditary diseases characterized by osteopenia, increased bone fragility, blue sclerae and dentinogenesis imperfecta. The abnormal synthesis of type-I collagen is responsible for the pathologic changes occurring not only in bone, but also in skin, tendons and ligaments, sclerae and teeth. The clinical and radiographic features of 5 cases (2 males and 3 females; age range: 1 month to 29 years) were analyzed. The patients were unrelated with each other. The diagnosis of the different types of osteogenesis imperfecta is as difficult as the identification of the various genotypes which are responsible for the different clinical pictures. The most characteristic radiographic pattern--which is observed in any type of the disease--consists in osteopenia associated, in most cases, with multiple fractures and deformities--e.g., micromelia, large metaphysis, archon long bones. Typically, "pop corn" calcifications are observed in both epiphysis and metaphysis of long bones. Dentinogenesis imperfecta is one of the most significant clinical patterns, and it can be the only bone abnormality. The prognosis of osteogenesis imperfecta is as varied as its genetics--i.e., the fractures discovered at birth are not necessarily a negative prognostic sign.

Adolescent↗
PubMed2003

[The expression of activin A and transforming growth factor-beta 1 during rabbit mandibual distraction osteogenesis].

OBJECTIVE: To examine the expression of activin A (ACT A) and transforming growth factor-beta 1 (TGF-beta 1) during mandibular lengthening and elucidate the difference between the role of ACT A and TGF-beta 1 during mandibular distraction osteogenesis. METHOD: Skeletally mature white new zealand rabbits were established right mandibular distraction osteogenesis model. The regenerating tissue of animals' lengthened mandibes were harvested at different time points to have immunohistochemistric research of ACT A, TGF-beta 1 protein and analysis ACT A, TGF-beta 1 mRNA by using RT-PCR semiquantitative mean. RESULTS: AT the end of latency period day, positive stain of ACT A were found in the osteoblasts while positive stain of TGF-beta 1 was found in mesenchymal cells. At the end of distraction phase, fibrosis tissue had no stain of ACT A, but had strong stain of TGF-beta 1. At the period of fixation days of 20 days, both cytoplasm of osteoblasts and extracellular matrix in primary mineralization front were strongly stained of ACT A. The osteoblasts, osteoid and osteocytes in peripheral new bone zone were moderately stained of ACT A. TGF-beta 1 had strongly positive stained in fibrosis zone and weekly positive stained in primary mineralization front and peripheral new bone zone. There were also broad activin A stains in cytoplasm of osteoblasts, osteoid and cytoplasm of ACT A, TGF-beta 1 in osteocytes after distraction for 30 days. Activin A mRNA began to express at the end of latency period. Expression for activin A mRNA increased gradually along with the beginning of distraction and at the peak in distraction of 10 days and 20 days, while TGF beta 1 mRNA increased at the peak at the end of latency period. CONCLUSION: ACT A and TGF beta 1 have different role during rabbit mandibular distraction osteogenesis.

Activins↗
PubMed2004

[Inducing human marrow mesenchymal stem cells into osteoblasts directionally and identification of their osteogenesis characteristics].

OBJECTIVE: To study the method of inducing human marrow mesenchymal stem cells (MSCs) into osteoblasts directionally and to identify osteogenesis characteristics. METHODS: MSCs were isolated from adult marrow using density gradient separation method and were cultured in conditioned medium containing Dex 10(-8) mol/L, beta-GP 10 mmol/L, and AA 50 micrograms/ml. The MSCs attachment formed soon and passage 3 cells were chosen to check osteogenesis characteristics, including alkaline phosphatase assay with modified calcium-cobalt staining method, type I collagen assay with immunohistochemistry, osteopontin and osteonectin assay with in situ hybridization and calcium nodes assay with Von Kossa staining. RESULTS: Passage 3 MSCs had typical appearance of osteoblasts and could be passaged continuously till passage 10. The rate of ALP expression was 85%. The expressions of collagen type I, osteopontin and osteonectin were positive and calcium nodes were seen by Von Kossa staining. CONCLUSION: We have successfully induced human MSCs into osteoblasts; the induced cells have typical osteogenesis characteristics.

Adolescent↗
PubMed2004

[The treatment of comminuted midfoot fractures with distraction osteogenesis].

OBJECTIVES: We evaluated the results of distraction osteogenesis with the Ilizarov circular external fixator in the treatment of comminuted fractures of the midfoot. METHODS: Four patients (1 female, 3 males) with comminuted midfoot fractures due to high energy trauma were treated with distraction osteogenesis performed by the Ilizarov circular external fixator. The mean age was 24 years (range 19 to 37 years). Fractures resulted from a traffic accident in one case, and from vehicle blast due to landmine explosion in three cases. The circular external fixator was applied for a mean of three months (range 2.5 to 4 months), during which the mean distraction was 10.5 mm (range 9 to 13 mm) at the fracture zone. The results were assessed according to the presence of pain and limping, radiographic measurements, and to the AOFAS (the American Orthopaedic Foot and Ankle Society) scoring system. The mean follow-up period was 58 months (range 33 to 81 months). RESULTS: All the patients had limping for a month following the removal of the fixator. At the end of six months, limping disappeared in one patient, decreased in two patients, and remained as a sequela in one patient. Pain which occurred during walking after the removal of the fixator decreased and finally disappeared within 3 to 6 months in three patients, but remained in one patient. Radiographic assessments were made using the anteroposterior and lateral X-rays of the foot. The mean AOFAS score was 70.5 (range 50 to 89). CONCLUSION: Distraction osteogenesis performed with the use of the Ilizarov circular external fixator may be an alternative in the treatment of comminuted foot fractures due to high energy traumas, where no other modality is likely to provide an anatomical reduction.

Adult↗
PubMed2004

[The effects of PL-derived growth factor on osteogenesis and skeletal reconstruction].

Platelet-derived growth factor (PDGF) plays an important role in osteogenesis and skeletal reconstruction. PDGF participates in the process of osteogenesis and bone absorption simultaneously. It stimulates the marrow stromal mesenchymal cell to proliferate and differentiate, accelerates the calcium aggradation into extracellular matrix, and stimulates chondrocytes proliferation and differentiation. Furthermore, PDGF can act on osteoclasts directly or indirectly to promote bone absorption. The dual-effects of PDGF facilitate osteogenesis and skeletal reconstruction.

Bone Remodeling↗