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At least 451 records · Page 25Linked to original sources
PubMedDate not supplied

Distraction osteogenesis in an anterior mandibular bone defect utilizing lingual periosteal release: a case report.

This clinical report presents a modified distraction technique to achieve height in the vector of distraction. The success of distraction osteogenesis depends on both biologic and biomechanical factors. The focus in this case is on correcting the direction of distraction; incorrect distraction direction is a frequent complication associated with distraction osteogenesis in the mandible. A 21-year-old man presented with a 10-mm vertical bone defect in the anterior mandible caused by facial trauma. The treatment chosen was distraction osteogenesis. After osteotomizing a bone segment and slitting the lingual periosteum, the bone segment was advanced anteriorly 4 mm and an extra-alveolar distraction device was applied. This approach allows the distraction device to be placed vertically, thus preventing lingual shift. The newly created alveolar ridge fully met prosthodontic requirements for a predictable outcome.

Adult↗
PubMed2005

Mandibular distraction osteogenesis for endosseous dental implants.

Patients with complete or partial edentulism who have insufficient bone for endosseous dental implant treatment present a challenge for the dental practitioner. Alveolar distraction osteogenesis is a technique for creating bone and soft tissue, without the need for bone grafting and its potential complications. In this article, alveolar distraction osteogenesis is compared with traditional bone grafting techniques. A case is presented to illustrate successful bilateral mandibular vertical distraction osteogenesis with creation of adequate bone volume for endosseous implant-supported dental restoration.

Alveolar Bone Loss↗
PubMed1992

Osteogenesis imperfecta. Radiographic classification, natural history, and treatment of spinal deformities.

The natural history of the radiographic changes associated with osteogenesis imperfecta was recorded for sixty-four patients. Detailed clinical data regarding spinal deformities were available for forty-three patients. The patients could be placed in six well defined groups on the basis of a cluster of radiographic changes. The radiographic criteria used to classify patients who had osteogenesis imperfecta included the shape, dimensions, and appearance of the long bones; the presence of a trefoil pelvis and protrusio acetabuli; and the shape of the vertebrae. Patients can be classified more accurately if the dynamic nature of the radiographic changes is appreciated. Patients who had Type-A disease, a mild form of osteogenesis imperfecta, maintained the contours of the vertebrae. Most had straight long bones except for five patients who had mild bowing. Patients who had Type-B disease had bowed long bones with wide cortices. The pelvis had a normal contour. The vertebral bodies were biconcave, and kyphosis and scoliosis developed. Patients who had Type-C disease had thin, bowed long bones, and protrusio acetabuli developed around the age of ten years. Patients who had Type-D disease had the same findings as those who had Type-C disease, with the additional finding of cystic changes around the knee by the age of five years. The physes closed early, and the cysts disappeared around the age of fifteen. Patients who had Type-C or D disease had development of severe spinal deformities. Patients who had Type-E disease were totally dependent functionally, and spinal deformities developed at a very early age. The long bones appeared to have no cortex. Patients who had Type-F disease had complete disruption of the ribs, which was incompatible with survival. The natural history of scoliosis in the patients who had Type-B, C, D, or E disease was one of progression of the curve. Bracing used in the treatment of scoliosis in one patient who had Type-E disease and five patients who had Type-C disease was unsuccessful. Arthrodesis of the spine prevented progression of the spinal deformities in patients who had Type-A disease, but the results of the operation were variable in the remaining types of the disease.

Adolescent↗
PubMedDate not supplied

[Distraction osteogenesis in the treatment of hemifacial microsomia].

PURPOSE: This report presents the results of distraction osteogenesis using an extra oral device in 28 patients with different grade of vertical mandibular ramus hypoplasia. MATERIAL AND METHOD: 28 patients (aged 2 to 15 years) with hemifacial microsomia underwent unilateral lengthening of the ascending ramus using unidirectional extraoral devices (Molina distractor). 3D-CT and cephalometric radiographs were analysed to determine the placement of the mandibular osteotomy and select the appropriate placement of the distraction device. RESULT: On the basis of one-year follow-up we can conclude that excellent, stable and functional mandibular lengthening was achieved with external distraction osteogenesis with minimal complications in all our patients. Coordinated growth between maxillary and mandibular arches with stable occlusion is observed. CONCLUSION: Mandibular distraction osteogenesis has proved to be an excellent technique for the treatment of mandibular deficiency. Careful and comprehensive planning of treatment, coupled with control of the distraction vector can bring about predictable results with minimal morbidity. Nevertheless. It is our conclusion that good and effective orthodontics within the period of consolidation is the key to achieve satisfactory stability results.

Adolescent↗
PubMed2005

Complication following intramedullary fixation with a Fixion nail in a patient with osteogenesis imperfecta: a case report.

Osteogenesis imperfecta (O.I.) is a genetic disorder with increased bone fragility and low bone mass. We report the history of a 17-year-old male patient with O.I. who presented a fracture of his left femoral shaft. He had osteogenesis imperfecta type I A according to Silence. He had presented two years previously an ipsilateral cervical fracture of the femur which had healed. Intramedullary fixation with a Fixion intramedullary nail was elected. While the Fixion nail was being inflated to 70 bars with saline, a longitudinal fracture occurred in the femoral shaft. A conventional intramedullary nail and cerclage wire were applied for fixation. The fracture healed without complication in 10 weeks. Based on this observation, we do not recommend using the Fixion IM nail for fracture fixation in patients who have abnormal bone fragility such as in osteogenesis imperfecta.

Adolescent↗
PubMed2005

[Methods for the evaluation of bone regeneration during distraction osteogenesis].

During limb lengthening gradual reconstruction of bone tissue in distraction gap requires constant, systematic control and evaluation. This process is depicted descriptively and subjectively. Changes happening during osteogenesis are dynamic, they can stop, slow down or accelerate, and regenerate may be of various shape and form. In this work different methods of bone regenerate evaluation are presented. They may be divided on two basic groups. First group contains methods with X-radiation, and the second - without X-rays. Examinations that evaluate arising bone regenerate may be also divided on descriptive examinations and quantitative. Despite that different methods are used for distraction osteogenesis course estimation, classic radiological examination remains the basic one. The rest of them are most often supplementary examinations, useful in selected stages of treatment, for e.g. ultrasonography in first stage of regenerate arising. So it seems, that future is in quantitative regenerate evaluation using radiographs. Classic X-ray picture made in reproducible and repeatable conditions may be subjected to digital, quantitative image analysis, and acquired results enables for more precise and more balanced evaluation of new bone formation in distraction osteogenesis.

Bone Regeneration↗
PubMedDate not supplied

Distraction osteogenesis versus autogenous onlay grafting. Part I: outcome of implant integration.

PURPOSE: The primary goal of this study was to compare bone-to-implant contact (BIC) in alveolar bone augmented by distraction osteogenesis with BIC in alveolar bone augmented by onlay iliac crest grafting. MATERIALS AND METHODS: Alveolar bone defects were created bilaterally in 5 American foxhounds, and after healing, bone augmentation was accomplished using distraction osteogenesis on 1 side of the jaw and onlay grafting on the other. Twelve weeks after consolidation, implants were placed in augmented and control sites. The animals were sacrificed and the jaws harvested for histologic analysis after an additional 8 weeks. RESULTS: The mean BIC was 54.7% +/- 14.6% for implants placed in distracted sites, 53.8% +/- 11.8% for sites where an onlay graft was used, and 51.2% +/- 14.4% for control sites. Significant differences in BIC were noted between experimental and control sites only at the apical third of the implant (19.8 +/- 1.8 for distracted sites; 15.5 +/- 1.5 for grafted sites; 8.0 +/- 0.5 for control sites; P < .05). DISCUSSION: The data showed that both distraction osteogenesis and onlay grafting produce sufficient bone for implant placement. There were no differences between procedures in regard to BIC after 8 weeks. CONCLUSION: These data suggest that both onlay grafting and vertical distraction are appropriate methods for bone augmentation prior to implant placement.

Alveolar Ridge Augmentation↗
PubMed2005

Effective maxillary orthopedic protraction for growing Class III patients: a clinical application simulates distraction osteogenesis.

The effective maxillary orthopedic protraction is an innovative technique for maxillary protraction in Class III growing patients. It includes three components: a new 2-hinged rapid maxillary expander for a greater amount of anterior displacement of maxilla, repetitive weekly protocol of Alternate Rapid Maxillary Expansion and Constriction (Alt-RAMEC) for disarticulating the maxilla, and intraoral maxillary protraction springs for non-compliant protraction. On average, the maxilla could be protracted for 5.8 mm in 3 months and the result remains stable at least 2 years later. The rationale for this technique is sutural expansion/ protraction osteogenesis. Sutural expansion/ protraction osteogenesis is a form of distraction osteogenesis. However, it still needs to be scrutinized experimentally for the sutural reactions corresponding to the effective maxillary orthopedic protraction.

Humans↗
PubMed2005

[Segmental mandibular reconstruction by elasticity distraction osteogenesis associated with guided bone regeneration].

OBJECTIVE: To accelerate distraction osteogenesis by utilizing guided bone regeneration technique, and to improve the automatic process of canine segmental mandibular reconstruction by elasticity distraction osteogenesis using shape memory metal alloy distractor. METHODS: Adult hybrid canines were used. Osteotomy was performed to remove a bone segment of 2.5-4.0 cm in one side of the mandible. Mandibular fixation devices and shape memory metal alloy distractor were secured according to the principles of bi-focal distraction technique. A piece of ePTFE membrane was sutured to cover the buccal side of bone defect and osteotomy gap of transport disc, where the periosteum was peeled for exposing mandible in operation. Then the incisions were totally closed. The canines were sacrificed 3 months later to harvest the mandibles for morphological observation and measurement of bone density and intensity. RESULTS: The shape memory metal alloy distractor performed distraction osteogenesis automatically and reconstructed the mandibles with bone defect. A regenerated bone segment of 1.5-2.0 cm was formed in the compression region between transport disc and contralateral mandibular end. The new bone in both of distraction and compression regions had similar height and thickness with normal mandible. Moreover the new bone density and intensity were rather satisfied. CONCLUSIONS: Membrane guided bone regeneration can avoid bone synthesis commonly caused by cicatrization of soft tissue in the bone defect, and accelerate ossification and maturation of new generated bone.

Animals↗
PubMed2006

[Distraction osteogenesis for treatment of unilateral temporomandibular joint ankylosis and secondary OSAHS in children: report of 4 cases].

PURPOSE: To evaluate the efficiency of distraction osteogenensis for treatment of unilateral temporomandibular joint ankylosis and secondary OSAHS in children. METHODS: 4 children with temporomandibular joint ankylosis and secondary OSAHS were retrospectively reviewed for their treatment. There were 2 males and 2 females, ranging from 5 to 13 years in age with the median of 6.5 years. Based on the history of the disease, the clinical manifestations, CT scan and PSG findings, the diagnosis was confirmed to be unilateral temporomandibular joint ankylosis and secondary OSAHS. All the patients were treated by gap arthroplasty to restore mouth opening, combined with mandibular body distraction osteogenesis for treatment of OSAHS. One-stage operation was performed on 3 patients, and two-stage operation on 1 patient. Unilateral and bilateral mandibular distraction osteogenesis was undergone on 2 patients individually. At the end of consolidation period of 3 months, the PSG examination was performed again and the distractor was removed. RESULTS: OSAHS was cured, the average AHI was lowered from 42.7 to 4.9, the average lowest saturation of blood oxygen rose from 74.3% to 89.8%, the average incisor distance reached 25.5mm compared to 6.5mm before surgery and facial deformity was corrected satisfactorily. Following up 38.1 months (13-58 months), no relapse appeared. CONCLUSION: Mandibular body distraction osteogenesis, combined with gap arthroplasty, could be the potential treatment modality for children with unilateral temporomandibular joint ankylosis, secondary OSAHS and facial asymmetry; it is recommended that both procedures be performed at the same time.

Adolescent↗
PubMedDate not supplied

Distraction osteogenesis versus autogenous onlay grafting. Part II: biology of regenerate and onlay bone.

PURPOSE: Few studies have directly compared the quality of bone generated by distraction osteogenesis with that generated by autogenous onlay grafting. The purpose of this study was to compare rates of bone turnover at 5 months in bone produced by distraction osteogenesis and onlay grafting. MATERIALS AND METHODS: Alveolar defects created in jaws of American foxhounds were augmented with distraction osteogenesis or onlay grafting and allowed to heal for 5 months. The animals were then sacrificed and the jaws were resected and prepared for decalcified and undecalcified histologic examination. RESULTS: Both procedures produced bone containing a mixture of haversian systems and trabecular bone. A significantly greater ratio of osteoblast-covered bone surface to total trabecular bone surface (mean +/- SEM) was noted in distraction bone (0.124 +/- 0.049) compared to onlay bone (0.081 +/- 0.048) or control host bone (0.085 +/- 0.042 microm) (P < .05). In addition, significantly (P <.05) greater numbers of osteoclasts per microm of bone surface were noted in distraction bone (0.939 +/- 0.07) compared to onlay bone (0.605 +/- 0.06) or control host bone (0.725 +/- 0.08). No differences in rates of mineralization were noted between the groups. DISCUSSION: While bone from both experimental groups appeared adequate for implant placement, distraction bone appeared to be remodeling at a higher rate than either onlay or control bone. CONCLUSION: Given that the state of healing of the bone in each of these comparative groups was examined at a static point in time, it is premature to draw conclusions about the efficacy of one procedure over the other.

Acid Phosphatase↗
PubMedDate not supplied

Low-dose intravenous pamidronate treatment in osteogenesis imperfecta.

Different therapy models have been tried in order to decrease bone resorption in osteogenesis imperfecta. Bisphosphonates are a group of drugs that mainly suppress osteoclast-mediated bone resorption, thus reducing bone turnover. We assessed the effects of low-dose bisphosphonate treatment in children with osteogenesis imperfecta. Sixteen osteogenesis imperfecta patients (12 female, 4 male) with severe deformities were treated with cyclic (3-4 mg/kg/year) intravenous infusions of bisphosphonate (Aredia-Novartis) therapy for a period ranging from 0.6 to 4.7 years (mean 2.50 +/- 1.09 years). Bone mineral density increased from 0.304 +/- 0.146 g/cm2 to 0.362 +/- 0.142 g/cm2 in the first year and to 0.421 +/- 0.146 g/cm2 in the second year. A clinical response was shown with a reduction in fracture rate and improvement in mobilization scores. Fracture rates decreased from a median of 4/year (0-30/year) before treatment to 0/year (0-5/year) during treatment. Ambulation improved in 10 children and remained unchanged in three. Two of the children were fully functional before therapy and one was below two years of age. No adverse effects were seen with pamidronate infusions of 7-10 mg/kg/year (monthly) or with 4 cycles/year 3-4 mg/kg/year. Low-dose cyclical pamidronate infusions markedly increased bone density and decreased bone fracture rate and should be considered as a part of a multi-disciplinary treatment.

Bone Density↗
PubMed2006

Osteogenesis imperfecta.

Osteogenesis imperfecta is an inherited disorder of the connective tissue. The extreme bone fragility seen in patients suffering from osteogenesis imperfecta pose a series of problems with regard to behavior management and rendering of quality dental treatment. Presented here a case of a four year old child suffering from osteogenesis imperfecta.

Alveolar Bone Loss↗
PubMed2006

[Simultaneous occlusal orthodontics during mandibular distraction osteogenesis].

OBJECTIVE: To study the significance and principle of simultaneous orthodontics during mandibular distraction osteogenesis. METHODS: Totally 11 patients simultaneously underwent occlusal orthodontic treatment for 3-4 months during mandibular distraction osteogenesis. Square-wire and elastic loops were adapted to perform the orthodontics by ways of more frequent adjustment of orthodontic device than routine method. RESULTS: All 11 patients with mandibular micronathia obtained the improved occlusion with their mandibular expected elongation, for instance, their open-bite and teeth displacement were partially corrected. CONCLUSION: Simultanous orthodontics with mandibular distraction osteogenesis may improve the malocclusion, decrease the orthodontic time, and lead the mandibular distraction direction.

Adolescent↗
PubMed2006

Right-sided cardiac involvement in osteogenesis imperfecta.

Skeletal manifestations are the hallmark of the osteogenesis imperfecta group of disorders. Extraskeletal involvement may, however, contribute significantly to morbidity. Structural cardiovascular anomalies reported in osteogenesis imperfecta include aortic root dilatation and aortic and mitral valve dysfunction. Herein is reported the first case of involvement of the right side of the heart in osteogenesis imperfecta.

Endothelium-Dependent Relaxing Factors↗
PubMed2006

[Experiment of using distraction osteogenesis to repair skull defect].

OBJECTIVE: To explore the possibility of using distraction osteogenesis to repair skull defect. METHODS: 17 goats with one year age were chosen randomly. The animals were divided to 3 groups. Group A includes 7 goats, a 3.0 cm x 2.2 cm rectangle skull defect is created on both sides of parietal area. Group B includes 5 goats, a 2.2 cm x 2.2 cm square skull defect was created on right side of parietal area. Group C includes 5 goats, a 3 cm x 1 cm rectangle skull defect was created on both sides of parietal area. Accordingly, different size of transport discs were created on right side of skull and the distraction apparatus is implanted. 3-D CT was done to measure the skull defect on group A. Biomechanical test was done on group B. Process of bone formation illustrated by histological stain, scan and transparent electric microscope was observed on group C. RESULTS: Group A measured by 3-D CT showed that skull defect of experimental side have been repaired by distraction osteogenesis. There was definitely difference between experimental and control side (P < 0.01). Group B measured by biomechanical test showed no definitely difference between experimental and normal side (maximum load P = 0.235 > 0.05, rigidity P = 0.213 > 0.05). Group C showed that the process of bone formation was typical intramembranous. CONCLUSIONS: The evidence showed that skull defect of goat can be repaired by distraction osteogenesis.

Animals↗
PubMed1991

Transgenic mice that express a mini-gene version of the human gene for type I procollagen (COL1A1) develop a phenotype resembling a lethal form of osteogenesis imperfecta.

A mini-gene version of the human gene for a pro-alpha 1(I) chain of type I procollagen (COL1A1) was prepared that contained -2.5 kilobases of the promoter region and the 5'- and 3'-ends of the gene but lacked a large central region containing 41 exons. The construct was modeled after a sporadic in-frame deletion of the human gene that produced a lethal variant of osteogenesis imperfecta, because it caused synthesis of shortened pro-alpha 1(I) chains that associated with normal pro-alpha 1(I) and pro-alpha 2(I) chains and caused degradation of both the shortened and normal pro-alpha chains through a process called procollagen suicide. The mini-gene was used to prepare transgenic mice. Eight of 15 transgenic mice expressed varying levels of the gene. All except one of the Fo founders were phenotypically normal, but several of the founders were apparently mosaic since they produced F1 progeny that died shortly after birth with a distinctive phenotype. The phenotype included extensive fractures of ribs and long bones similar to the fractures seen in lethal variants of osteogenesis imperfecta. Mice with the lethal phenotype expressed much higher levels of the mini-gene than transgenic mice without the lethal phenotype. Experiments with cultured skin fibroblasts from the transgenic mice demonstrated that shortened pro-alpha 1(I) chains synthesized from the mini-gene became disulfide-linked to pro-alpha 1(I) chains synthesized from the endogenous mouse gene. The results demonstrate that a mutated type I procollagen gene based on the model of procollagen suicide can be used to produce a severe phenotype of osteogenesis imperfecta that is genetically transmitted.

Animals↗
PubMed1991

[Successful mitral valve replacement in osteogenesis imperfecta--a case report].

A 34-year-old man with osteogenesis imperfecta who underwent successful mitral valve replacement due to mitral regurgitation was reported. Cardiac disease associated with osteogenesis imperfecta is very rare and only fifteen patients were operated under the extracorporeal circulation previously. While excessive hemorrhage due to tissue fragility was observed in 7 of 15 patients, perioperative course of the case reported here was completely uneventful. The difference of hemorrhagic tendency as well as etiology of osteogenesis imperfecta will be defined according to the advance of technology in collagen genetics and biochemistry in future.

Adult↗