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At least 703 records · Page 39Linked to original sources
PubMed2002

Dentoalveolar distraction osteogenesis for rapid orthodontic canine retraction.

PURPOSE: We present a technique to reduce the overall orthodontic treatment time by means of dentoalveolar distraction osteogenesis. PATIENTS AND METHODS: Eleven patients who were planned to undergo orthodontic treatment with bilateral first premolar extractions and subsequent bilateral canine tooth distalization underwent osteotomy around the canine tooth. The first premolar was extracted, and the buccal bone was carefully removed. After wound closure, a special orthopedic device was mounted and cemented to the first molar and canine teeth. Distraction was started the same day at the rate of 0.4 mm twice a day and continued until adequate movement of the canine teeth was achieved. The device was then removed, and orthodontic therapy was continued with fixed appliances. RESULTS: The distraction rate and the device were well tolerated by all of patients. No anchorage loss in the second premolar and first molar teeth, root resorption, dental ankylosis, discoloration, or loss of vitality was detected. CONCLUSION: The concept of distraction osteogenesis for rapid orthodontic tooth movement is promising and feasible for clinical practice.

Adolescent↗
PubMed2003

Histomorphometric evaluation of short-term changes in masseter muscle after lengthening the rabbit mandible by distraction osteogenesis.

PURPOSE: Structural changes in muscles may affect the process during and after distraction osteogenesis (DO) of the mandible. However, the response of the masticatory muscles is still not well defined after gradual lengthening of the mandible. In this experimental study, short-term structural changes in masseter muscles of the rabbits are evaluated after mandibular DO. MATERIALS AND METHODS: Left mandibles of 10 New Zealand rabbits were lengthened by DO for 7 days in the rate of 1 mm/day. Mandibles of all animals were removed at the end of the consolidation period. Muscle biopsy samples of distracted and contralateral sides were histopathologically investigated, and histomorphometric results were statistically analyzed. RESULTS: Atrophy, hypertrophy, regeneration, and concomitant mild interstitial edema and fibrosis were found more evident in experimental side biopsy samples 30 days after distraction. Histomorphometric analysis revealed a statistically significant decrease in the mean regions of masseter muscle fibers of the distracted sides compared with the control sides (P <.05). CONCLUSION: This experimental study showed that the structure of masseter muscle is influenced during and shortly after mandibular distraction osteogenesis. Atrophic changes of the ipsilateral masseter muscles may be regarded as regenerative response that occurs during and shortly after distraction period.

Animals↗
PubMed2000

A novel modular retention system for midfacial distraction osteogenesis.

Distraction osteogenesis of the midface offers new possibilities for the treatment of large sagittal discrepancies between the upper and lower jaws. The use of an extraoral halo-borne distractor, which allows free three-dimensional vector control, may cause problems in the connection between the midface and the distractor. To overcome these difficulties, we present a new modular retention system to gain bone anchorage whenever a toothborne appliance is not suitable. Distraction osteogenesis with an extraoral appliance is therefore possible even in edentulous elderly patients. We have used this system successfully in 11 patients.

Bone Plates↗
PubMed2001

Distraction osteogenesis of the maxilla and midface using a subcutaneous device: report of four cases.

The use of distraction osteogenesis in the hypoplastic maxilla and midface is still controversial. Since the beginning of 1998, 25 patients have been treated with osteodistraction techniques for various reasons. Among them were four patients who were treated by high LeFort I osteotomies and insertion of a newly developed subcutaneous distraction device in the malar region. Distraction osteogenesis was successful in all four cases resulting in a mean sagittal bone gain of 12.0 mm (range 7-14) at the level of distractor fixation. All patients were kept under orthodontic supervision during osteodistraction. The final occlusal relation was satisfactory. Cephalometric measurements after distraction showed an anterior rotational movement of the midface region. As the question of relapse and further growth is still not clear, Delaire masks are used to stabilize the surgical result after removal of the distractor. The importance of long-term follow-up is stressed.

Adolescent↗
PubMed2001

The effect of growth hormone on insulin-like growth factor I and bone metabolism in distraction osteogenesis.

Limb lengthening in the left tibia of 30 mature female Yucatan micropigs was performed using distraction osteogenesis. A treatment group of 15 animals received recombinant porcine growth hormone (r-pGH) (100 microg/kg/day) while the others served as controls. Serial serum measurements of total insulin-like growth factor I (IGF-I), free IGF-I, IGF binding proteins -1, -2, -3 and -4 (IGFBP-1 to -4) were performed. Bone-specific alkaline phosphatase (bone-ALP) and the serum carboxyl-terminal telopeptide of type I collagen (ICTP) were measured as bone turnover markers. The GH-treated animals showed a significant increase in total IGF-I, free IGF-I and IGFBP-3 after surgery (P<0.001). Similarly, the treated animals showed a significantly higher level of bone-ALP (P<0.001) throughout the experiment compared to the controls. There was a significant correlation between bone-ALP and total IGF-I (r=0.76) in the GH-treated group and an even higher correlation for free IGF-I (r=0.90). There was no difference in the ICTP serum levels between the two groups. These data indicate that the application of species-specific growth hormone results in a stimulation of bone formation in distraction osteogenesis which may be mediated by IGF-I. The stronger correlation between free IGF-I and bone-ALP indicates that the anabolic effect of IGF-I may be regulated through the IGFBPs by binding and inactivating IGF-I.

Alkaline Phosphatase↗
PubMed2003

Response of Schwann cells in the inferior alveolar nerve to distraction osteogenesis: an ultrastructural and immunohistochemical study.

The biological mechanisms of nerve adaptation to distraction osteogenesis have not yet been elucidated. This study observed response of Schwann cells in the inferior alveolar nerve (IAN) following mandibular lengthening by electron microscopy and immunohistochemistry of S-100 protein, a specific marker of Schwann cells. Unilateral mandibular distraction (10mm elongation) was performed in nine young adult goats. Three animals were sacrificed at 7, 14 and 28 days after completion of distraction, respectively. The distracted IAN specimens and control nerves (from the contralateral sides) were harvested and processed for histological, ultrastructural and immunohistochemical examinations. Wallerian degeneration was observed in the distracted IAN, and Signs of axonal regeneration, as well as many activated Schwann cells were seen in the lengthened nerves. The expression of S-100 protein increased significantly at early stage of distraction osteogenesis, but almost returned to the normal level at 28 days after distraction. This study suggests that Wallerian degeneration caused by mechanical stretching may stimulate Schwann cells to enter a proliferated and activated state. Schwann cells and S-100 protein appear to play crucial roles in axonal regeneration that contributes to nerve adaptation to gradual distraction. Therefore, the IAN injury caused by mandibular gradual distraction was not serious; it seems to recover totally through a complicated repair mechanism.

Adaptation, Biological↗
PubMed2000

Does the sheep mandible relapse following lengthening by distraction osteogenesis?

AIM: Distraction osteogenesis is a technique used to lengthen the shortened mandible. However, the long term stability of the distracted mandibular bone is not known. The aim of this study was to assess if the sheep mandible relapses following lengthening, and to assess the quality of distracted bone up to 1 year post lengthening. METHODS: Twenty-four sheep had bilateral external mandibular distractors applied, with three sheep as controls. Titanium marker screws were positioned both proximal and distal to the distraction zone in all sheep. Following a 5 day latency period, the interdental gap was distracted 1 mm/day for 20 days, with a subsequent 20 day consolidation period. Ante-mortem serial X-rays were used to assess for relapse by measuring the distance between the screws. The animals were sacrificed at either 3, 6, 9 or 12 months post-distraction. At post mortem, the distance between the screws was re-measured. The distracted bone was assessed mechanically and histologically. RESULTS: The mean mandibular lengthening obtained was 13.2 mm. There was no relapse of the mandible over 12 months. The distracted bone had attained the strength and stiffness of undistracted bone by 6 months post-distraction (p < 0.05). Histological evaluation revealed significant amounts of lamellar bone by 6 months post-distraction. CONCLUSIONS: No relapse occurred for 12 months post distraction lengthening. The bone formed following distraction was stable and of good quality. These findings lend support to the use of distraction osteogenesis in clinical practice.

Analysis of Variance↗
PubMed2001

Intraoral mandibular distraction osteogenesis: special attention to treatment planning.

PURPOSE: To demonstrate our experience using internal devices for unidirectional distraction osteogenesis in treating different mandibular hypoplasias (with or without maxillary deformities). An algorithmic table for diagnosis, and treatment planning is presented. PATIENTS AND METHODS: Twenty internal distraction devices were used in 16 patients with mandibular hypoplasia. Deficiency in length of the mandible was calculated on three-dimensional computed tomography scans. The device was activated by a transcutaneous pin on the fifth postoperative day. Distraction was achieved at rates of 0.5 mm/12 h. After a variable period of consolidation the devices were removed. Mean follow-up was 18 months. RESULTS: Successful distraction osteogenesis was achieved in all patients. No premature consolidation or pseudoarthrosis was observed. Improvement of facial aesthetics was produced in all cases. Final occlusion was excellent in those cases where no simultaneous maxillary deformity was present. Orthodontic treatment was applied in all cases. Results remained stable one year postoperatively. CONCLUSIONS: The occlusal results obtained in this series show that we can plan distraction as a definitive treatment in cases with isolated mandibular hypoplasia. When an additional maxillary deformity is present, mandibular distraction must be performed first if indicated, but a maxillary procedure will be necessary later.

Adolescent↗
PubMed1979

[Treatment of osteogenesis imperfecta with (+)-catechin (author's transl)].

4 girls aged 4--12 years with various forms of osteogenesis imperfecta were treated with (+)-catechin for several months. Bone punch biopsies from the iliac crest were investigated by electron microscopy before and during treatment. The frequency of fractures decreased clinically. There were no radiographic changes in the bones and there were no side effects. Electron microsopy showed a dilated coarse endoplasmatic reticulum with infrequent ribosomes, thin collagen fibrils and decreased predominantly disseminated mineralisation before treatment. Under the influence of treatment electron microscopical aspects of the bone improved. The cisternae of the endoplasmatic reticulum were arranged parallel with densely packed ribosomes, collagen fibrils were wider and in closely packed bundles and mineralisation was clearly improved. The electron microscopic findings are evidence for a possibly beneficial influence of (+)-catechin in some cases of osteogenesis imperfecta.

Benzopyrans↗
PubMedDate not supplied

[Intraoperative hyperpyrexia in patients with osteogenesis imperfecta].

The aim of this study was to evaluate the influence of different types of anesthesia upon the intra- and postoperative body temperature in osteogenesis imperfecta patients. The development of an intraoperative hyperpyrexia of unknown origin is a typical phenomenon in patients with osteogenesis imperfecta. Body temperatures of up to 40 degrees C are known to complicate the operation. Therefore, in a retrospective study, the pre-, intra- and postoperative body temperature curves of 45 operations under different anaesthesias were measured. Group A underwent a common balanced anaesthesia with the volatile anaesthetic Enfluran in combination with Fentanyl, while group B was operated on under total intravenous anaesthesia (TIVA) with Propofol and Alfentanil. The preoperative temperatures were not different in the two groups. The intraoperative curves showed a constant body core temperature or even an increase under Enfluran, while the temperature always decreased under TIVA. This could be confirmed by intraindividual studies in 5 patients.

Adolescent↗
PubMed1994

[Prenatal diagnosis of osteogenesis imperfecta. Report of a case classified as the classical Ekman Lobstein type].

Report on prenatal sonographic diagnosis of osteogenesis imperfecta of the classical type Ekman Lobstein (osteopsathyrosis) in the 35th week of pregnancy. We could demonstrate the marked penetration of ultrasound through the characteristically very thin long bones even before the occurrence of fractures. Difficulties in attributing our case to one of the four groups of osteogenesis imperfecta according to Sillence are discussed, as well as the obstetrical management of these prenatally diagnosed cases.

Adult↗
PubMed1980

[Osteogenesis imperfecta in pregnancy (author's transl)].

Osteogenesis imperfecta is one of the most frequent hereditary anomalies. One personal case is described. The literature is reviewed. The disease entity, the heredity and the possibilities of antenatal diagnosis are described. A pregnant patient with osteogenesis imperfecta needs careful antenatal care. Delivery by primary Caesarean section with gentle delivery of the infant is the method of choice. The aim of the method of delivery is to avoid spontaneous fractures during the delivery.

Adult↗
PubMedDate not supplied

[Osteogenesis in exposure to ionizing radiation in vitro].

Irradiation is a well established therapeutical concept to prevent heterotopic ossification after joint replacement. The influence of irradiation on proliferation of mature osteoblasts and their potential osteoprogenitors, matrix formation and mineralization are not well known in this setting. We therefore studied the effect of different doses of ionizing irradiation on the several steps of osteogenesis in vitro, using cells isolated from the juvenile rat. A colony forming test, the MTT-viability assay, a cell count, measurement of the cellular protein content and alkaline phosphatase activity, as well as determination of in vitro mineralisation have been applied to calvarian osteoblasts, fibroblasts and stromal bone marrow cells. Irradiation results in a dose-dependent suppression of clonogenic activity in all mitotically active cells, but metabolic activity and matrix synthesis were not impaired. In dense cultures alkaline phosphatase expression and in vitro mineralisation were not significantly affected by irradiation. Our experimental in vitro data suggest that irradiation inhibits the initial phase of in vivo osteogenesis due to the cytostatic effect. Postoperative irradiation after THR must therefore take place as early as possible. The homoeostasis of normal, orthotopic bone does not seem to be severely affected by local low-dose irradiation.

Alkaline Phosphatase↗
PubMedDate not supplied

[Effects of mellitic acid on matrix-induced, ectopic osteogenesis in the rat].

Similar to diphosphonates mellitic acid is characterized by its high affinity to Calcium-phosphate-minerals. Mellitic acid inhibits the crystallization of hydroxyapatite in vitro and in vivo. Local application of mellitic acid (concentration 1 mmol/l) proved not to impair osteoinduction and development of nature bone in the matrixinduced ectopic osteogenesis. But in the course of osteogenesis prominent masses of cartilage developed. Higher local concentrations of mellitic acid may be efficient in the therapy of ectopic ossification, but also may be accompanied by formation of crystal deposition.

Animals↗
PubMed1998

Effect of distraction osteogenesis on the peripheral nerve: experimental study in the rat.

Distraction osteogenesis is the current method of choice for bone lengthening. Despite the gain in experience, various complications are reported, among them, adverse effects on peripheral-nerve function. In order to thoroughly investigate the effect of distraction on neural tissue, a distraction osteogenesis model in the rat was established, using the femur of 30 Sprague-Dawley rats. The animals were randomized in three groups, following different rates of distraction (0.5 mm, 1.0 mm, and 1.5 mm/day) for 50, 25, and 16 days, respectively, so that the final length of distraction was the same in all groups. The mean sciatic function index ranged near normal in all groups. All groups demonstrated decrease of conduction velocity and the area under the curve of the compound action potential, while morphologic alterations consisted of decrease in the number of axons and evidence of active degeneration. Animals in Groups 1 (0.5 mm/day) and 2 (1 mm/day) displayed comparable changes, while in Group 3 animals (1.5 mm/day), changes were significantly more adversely dramatic. The safest and fastest rate of distraction in this rat model was determined to be 1 mm/day.

Action Potentials↗
PubMedDate not supplied

[Experiences with the operative therapy of osteogenesis imperfecta].

Osteogenesis imperfecta is one of the commonest congenital systemic diseases. The treatment of the fractures caused by the diseases and the growth deficiencies which result is mainly conservative. Taking 22 operations on patient suffering from osteogenesis imperfecta, the results of the treatment are reported and the cases in which an operation is indicated are discussed. As the osteosynthesis material selected, the intramedullary Rush pin has proved its worth. No serious complications were observed.

Child↗
PubMed1994

[Acute mitral insufficiency in osteogenesis imperfecta].

A 56-year-old woman with known osteogenesis imperfecta tarda but no obvious sign of cardiac disease developed increasing dyspnoea, eventually even at rest, with blood-streaked sputum over a period of 10 days. The chest radiograph demonstrated intraalveolar pulmonary oedema. Transthoracic echocardiography revealed as the likely cause of these signs chordal rupture of the anterior leaflet of the mitral valve with mitral regurgitation. After treatment of the cardiac failure with frusemide (up to 500 mg daily intravenously), nitrates and captopril (25 mg daily by mouth) the diagnosis was confirmed by transoesophageal echocardiography. Elective replacement of the mitral and aortic valves was performed 6 months later. Acid mucopolysaccharides were demonstrated histologically in the valvar stroma, a finding consistent with osteogenesis imperfecta. Echocardiography should be performed routinely in connective-tissue disease to reveal any possible cardiovascular involvement.

Aortic Valve↗