Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Osteogenesis, Distraction”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 739 records · Page 41Linked to original sources
PubMed2006

Severe proliferative congenital temporomandibular joint ankylosis: a proposed treatment protocol utilizing distraction osteogenesis.

The classical treatment for temporomandibular joint (TMJ) ankylosis in children: 1) joint release; 2) arthroplasty; 3) reconstruction; and 4) postoperative physical therapy (PT), is often unsuccessful. Postoperative physical therapy is difficult in the young patient due to poor cooperation. Moreover, there is a subgroup of patients who have a refractory congenital proliferative bony process that is the cause of their disease. In these patients, a role for distraction osteogenesis (DO) has been defined. We present a series of young patients with congenital proliferative TMJ ankylosis. Some have failed classic treatment. In such cases, DO is used to expand the mandibular size and soft tissue matrix. This creates a static open bite, facilitates mid-facial growth, and avoids compromise of the airway, speech, nutrition, and oral hygiene. To maintain these objectives, mandibular DO may be repeated as the child matures. Once skeletal maturity is reached, DO is used to normalize occlusion and further expand the soft tissue envelope prior to definitive reconstruction and aggressive post-op PT. In seven patients, this protocol has been used. Five patients are currently in the active phase of growth and undergoing interim treatment with mandibular DO. Two patients have reached skeletal maturity and have completed the protocol of DO with definitive arthroplasty and reconstruction. DO is a valuable aid in the treatment of the problematic child with congenital proliferative TMJ ankylosis. Interim DO, prior to definitive arthroplasty and reconstruction, can provide a static open bite that prevents progressive deformity and its associated functional disturbances.

Ankylosis↗
PubMed2005

Rapid canine retraction and orthodontic treatment with dentoalveolar distraction osteogenesis.

PURPOSE: Duration of treatment is one of the things orthodontic patients complain about most. To shorten treatment time, a new technique of rapid canine retraction through distraction osteogenesis was introduced. The effects of dentoalveolar distraction on the dentofacial structures are presented in this article. MATERIAL: The study sample consisted of 20 maxillary canines in 10 growing or adult subjects (mean age, 16.53 years; range, 13.08-25.67 years). First premolars were extracted, the dentoalveolar distraction surgical procedure performed, and a custom-made intraoral, rigid, tooth-borne distraction device was placed. The canines were moved rapidly into the extraction sites in 8 to 14 days, at a rate of 0.8 mm per day. RESULTS: Full retraction of the canines was achieved in a mean time of 10.05 (+/-2.01) days. The anchorage teeth were able to withstand the retraction forces with minimal anchorage loss. The mean change in canine inclination was 13.15 degrees +/- 4.65 degrees, anterior face height and mandibular plane angle increased, and overjet decreased significantly at the end of dentoalveolar distraction. No clinical and radiographic evidence of complications, such as root fracture, root resorption, ankylosis, periodontal problems, and soft tissue dehiscence, was observed. Patients had minimal to moderate discomfort after the surgery. CONCLUSIONS: The dentoalveolar distraction technique is an innovative method that reduces overall orthodontic treatment time by nearly 50%, with no unfavorable effects on surrounding structures.

Adolescent↗
PubMed2005

[Effects of maxillary distraction osteogenesis on the velopharyngeal configuration of cleft palate patients].

OBJECTIVE: To study the effects of internal maxillary distraction osteogenesis(DO) on the velopharyngeal configuration of cleft palate patients. METHODS: Ten patients with severe maxillary hypoplasia secondary to cleft lip and palate patients (7 males and 3 females, average age 20.1 years old) had undertaken high step LeFort I osteotomy, and internal maxillary distraction devices were applied to advance the maxilla. Before surgery, when DO was completed and 6 months after DO was completed, oriented lateral cephalograms at rest position of each patient were taken, and 6 measure indexes of velopharyngeal configuration were collected and analyzed. RESULTS: All patients had successfully accomplished maxillary DO and the maxilla had been averagely advanced 11.3 mm. PNS-PhW, C-PhW, UL and ANS-PNS-T had all significantly increased, and UD had significantly decreased when DO was completed and 6 months after DO was completed as compared with pre-surgery. No significant linear correlation was found between maxilla advancement distance and velopharyngeal configuration changes. CONCLUSION: Correction of maxillary hypoplasia secondary to cleft palate surgery by using internal maxillary DO can increase the velopharyngeal cavity depth, and may impair velopharyngeal competence, but the compensatory changes of velopharyngeal soft tissue can alleviate this impairment to certain extent.

Adolescent↗
PubMed2004

Treatment of mandibular retrusion by distraction osteogenesis: a new technique.

We treated the mandibular retrusion of a 20-year-old man by distraction osteogenesis. Our aim was to avoid any visible discontinuities in the soft tissue profile that may result from conventional "one-step" genioplasty. The result was excellent. In addition to a good aesthetic outcome, there was increased bone formation not only between the two surfaces of the osteotomy but also adjacent to the distraction zone, resulting in improved coverage of the roots of the lower incisors. Only a few patients have been treated so far, but the method seems to hold promise for the treatment of extreme retrognathism, as these patients often have insufficient buccal bone coverage.

Adult↗
PubMedDate not supplied

Distraction osteogenesis for treatment of premature physeal closure and shortening of the third and fourth metatarsals of a dog.

A 4-month-old Siberian husky was presented for a history of lameness of the left hind limb. Physical and radiographic examination revealed a 1-cm shortening of metatarsals III and IV, with subsequent hyperextension of the digits on the left hind paw. A circular external skeletal fixator was used to accomplish distraction osteogenesis in both metatarsals over a period of 15 days. Treatment was successful in restoring appropriate length of the metatarsals and in resolution of the lameness. At 6 and 12 months after surgery, the owner reported that the dog was ambulating normally and had no complications related to the surgery.

Animals↗
PubMed2001

The effect of aging on distraction osteogenesis in the rat.

The effect of age on bone formation in the limb lengthening model of distraction osteogenesis (DO) was investigated in two studies using Sprague-Dawley (SD) rats from two colonies at various ages (CAMM: 9 vs 24 months, Harlan: 4 vs 24 months). External fixators were placed on the right tibiae of 30 male SD rats (20 CAMM, 10 Harlan) and mid-diaphyseal osteotomies were performed. Distraction was performed at 0.2 mm bid for 20 days (CAMM) or 14 days (Harlan). The experimental (DO) and control (contra-lateral) tibiae were removed for high-resolution radiography and decalcified histology. Videomicroscopy was used to quantitate radiodensity, histology (matrix type) and relative areas of cell proliferation, which was identified by proliferating cell nuclear antigen (PCNA) immunochemistry. Both studies demonstrated an age-related decrease in the percent mineralized bone (radiodensity) in the distraction gap (CAMM 9 vs 24 months: 68% vs 51%, P < 0.003; Harlan 4 vs 24 months: 95% vs 36%, P < 0.001) and no significant colony or distraction time-specific difference was seen between the two colonies of 24-month-old rats. Histology was performed on the Harlan rats. The DO gaps in the 24-month-old rats demonstrated less endosteal new bone compared to the 4-month-old rats (P < 0.01), but equivalent periosteal new bone. In 4-month-old rats, PCNA-immunostained cells were organized along the primary matrix front (where the first deposition of osteoid occurs) extending across both periosteal and endosteal surfaces. In 24-month-old rats, PCNA+ cells were organized in zones along the periosteal new bone fronts only and irregularly scattered throughout the endosteal gap within a fibrovascular non-ossifying matrix. These results indicate that 24-month-old rats have a relative deficit in endosteal bone formation which may not be related to cell proliferation but rather to cell organization. This model reflects the clinical situation where radiographic findings in older patients demonstrate significant delays in mineralization during DO. We believe this model of DO in aged rats presents unique in vivo opportunities to test hypotheses concerning (1) the effects of aging on bone repair, (2) the effects of pharmacological agents on bone repair in a geriatric setting, and (3) to study the mechanisms underlying DO.

Aging↗
PubMed2006

Modified bimaxillary distraction osteogenesis: a technique to correct facial asymmetry.

AIM: To study the efficacy of modified simultaneous maxillary-mandibular distraction to correct facial asymmetry in patients with compensated occlusion and a canted occlusal plane. PATIENTS AND METHODS: During the period January 1998-December 2003, 15 patients with facial asymmetry (8 male and 7 female, mean age 18 years) were treated using a modified technique of simultaneous maxillary-mandibular distraction. Their facial deformities were caused by hemicraniofacial microsomia (n=6) or ankylosis of the temporomandibular joint (TMJ) (n=9). RESULTS: The mean (range) gain in mandibular height was 16 (13-22) mm, and increase in elongation 14 (11-18) mm achieved over 11-22 days. Predicted movement on cephalometric analysis correlated closely with the actual distraction (mean accuracy 0.4mm). CONCLUSION: Simultaneous bimaxillary distraction osteogenesis is a robust technique that provides the surgeon with the ability to correct facial asymmetry in patients with hemicraniofacial microsomia and those with facial deformity after ankylosis of the TMJ. A cephalometric prediction tracing made before distraction is a reliable guide to the actual distraction needed to correct the facial deformities in these patients.

Adolescent↗
PubMed2005

Maxillary bone transportation in alveolar cleft-transport distraction osteogenesis for treatment of alveolar cleft repair.

Secondary autogenous cancellous bone grafting is a widely used method for the treatment of alveolar clefts and oronasal fistulae. However, failure of iliac bone grafting sometimes occurs due to inadequate covering with the surrounding soft tissue and marked scar formation, inappropriate patient age, or large clefts. For alveolar clefts, we developed a method consisting of alveolar bone transportation, closure of the alveolar cleft, and/or grafting of new bone. Transport distraction osteogenesis along the curve of the dental arch is ideal. Alveolar bone was transported in the planned direction using a ready-made bone-borne distractor in combination with an orthodontic arch wire for transport guidance. This method allows simultaneous correction of nasal septal deviation and also correction of maxillary arch deformities and malocclusion since, the dental arch is expanded without donor sacrifice. This method can be regarded as tissue engineering to expand bone tissue. This method can be safely performed not only in patients undergoing initial treatment for alveolar clefts but also in patients in whom bone grafting has failed. Since 1997, we have performed this method in 22 patients and obtained good results.

Adolescent↗
PubMed2003

Intra-alveolar distraction osteogenesis in preparation for dental implant placement combined with orthodontic/orthognathic surgical treatment: a case report.

The use of implants has become a routine part of restorative dental treatment. The placement of implants requires a sufficient quantity of bone in which to place implant fixtures. Where such bone does not exist, a number of methods have been used to augment the affected area of the alveolar ridge. This case report describes the use of the relatively new distraction osteogenesis procedure to increase bone volume in a patient who required post-traumatic restoration of several missing teeth, as well as comprehensive orthodontic and orthognathic surgical treatment.

Adolescent↗
PubMed2001

Imaging the neonatal mandible for accurate distraction osteogenesis.

The position of mandibular teeth is difficult to document in the neonatal patient. Panorex images are difficult to obtain in an uncooperative pediatric patient. The new technique presented by the authors uses computed tomographic data to create a curved, reformatted image of the mandible, and generates an image similar to a panorex image. This curved, reformatted mandibular image provides accurate visualization of the mandible and mandibular teeth. This technique allows for precise pin placement and osteotomy in distraction osteogenesis.

Humans↗
PubMed2002

Distraction osteogenesis in adult obstructive sleep apnea surgery: a preliminary report.

PURPOSE: This study evaluated the potential application of distraction osteogenesis (DO) for skeletal expansion in the management of adult patients with obstructive sleep apnea syndrome (OSAS). PATIENTS AND METHODS: Five consecutive adult patients (3 male, 2 female) underwent a DO procedure with intraoral distraction devices for the management of OSAS. The surgical procedures were mandibular advancement (n = 4, with 3 bilateral advancement and 1 unilateral advancement) and simultaneous maxillomandibular advancement (n = 1). Starting 7 days after surgery, the distraction devices were activated 4 times daily at a rate of 1.0 mm/d until the desired skeletal expansion was achieved. All of the patients underwent pre- and postoperative radiographic analysis and polysomnography. The distraction devices were removed 3 months after the completion of the distraction process. RESULTS: The amount of skeletal advancement by distraction ranged from 5.5 to 12.5 mm, with the mean distance being 8.1 mm. The postoperative polysomnographic results showed improvement of OSAS in all 5 patients with an improvement of the mean RDI from 49.3 events per hour to 6.6 events per hour. The lowest oxygen saturation improved from 79.8% to 85.8%. The mean follow-up period was 12 months. Complications included localized inflammation at the distraction device site (n = 2), temporary temporomandibular joint (TMJ) discomfort during distraction process (n = 1), and temporary paresthesia of the inferior alveolar nerve distribution (n = 2). A moderate amount of pain during the activation of the distraction devices was reported (n = 3) and was adequately treated with analgesics. None of the complications led to permanent problems. CONCLUSION: This limited case series shows that DO is applicable in selected adult patients for skeletal advancement in the treatment of OSAS. However, there are disadvantages with the use of DO, and further investigations are necessary to determine the potential of this technique.

Adult↗
PubMed1997

Mandibular widening by intraoral distraction osteogenesis.

Transverse mandibular deficiency with crowding of the mandibular anterior teeth is frequently present in patients with Class I and II malocclusions. The hallmarks of treatment by compensating orthodontics, functional appliances or orthopaedic devices are instability, compromised periodontium and compromised facial aesthetics. A new surgical technique has been developed to widen the mandible. The method is based upon gradual osteodistraction following vertical interdental symphyseal osteotomy. Ten patients with transverse mandibular deficiency and significant dental crowding were treated by symphyseal distraction and subsequent non-extraction decompensating orthodontic treatment. Either an intraoral tooth-borne Hyrax appliance or a new custom-made bone-borne osteodistractor was used to gradually widen the mandible. The surgical procedures were accomplished under local anaesthesia and intravenous sedation in an ambulatory surgical setting using an individualized distraction protocol. The appliances were activated 7 days after symphyseal osteotomies, once each day at a rate of 1 mm per day and stabilized for 30-40 days after distraction. After the segments were distracted, non-extraction orthodontic alignment of the mandibular anterior teeth was accomplished. The symphyseal distraction gaps were bridged by new bony regenerate. Distraction osteogenesis provided an efficient surgical alternative to orthognathic surgery for widening the mandible and treatment of transverse mandibular deficiency without extraction of teeth.

Adolescent↗
PubMed2003

Cephalometric evaluation of the craniofacial complex in patients treated with an intraoral distraction osteogenesis device: a preliminary report.

The purpose of this pilot study was to evaluate cephalometrically the efficacy of an intraoral distraction osteogenesis device in treating patients with unilateral mandibular hypoplasia. Six patients with hemifacial microsomia underwent unilateral mandibular distraction. Posteroanterior and 45 degrees lateral oblique cephalograms were measured, and changes in maxillary width and height, occlusal height, ramus height, mandibular length, and chin position were quantified. Measurements were taken preoperatively and postoperatively at 7 time points (T1-T7) over 2 years. Calculations for statistical significance were done to T6 for all patients and through T7 for 4 patients. The means and variances were calculated for the 6 cephalometric variables for each time point. The mean differences between treatment and control were calculated as well as analysis of variance. Mean differences between specific time periods were measured by pairwise comparison with significance determined at the 0.05 level of confidence. Statistical analysis was used for descriptive purposes only. The cephalometric data suggest that the intraoral distractor is as capable of lengthening hypoplastic mandibles as the initial extroral appliances. The bone lengthening appears stable, with the distracted side of the mandible maintaining a growth rate similar to the normal side. Immediately after distraction, transient improvements were noted in maxillary height, ramal height, and maxillary width. All patients demonstrated an immediate improvement in chin position toward the skeletal midline; however, after T4, menton appeared to be moving away from the midline over time.

Adolescent↗
PubMed2005

Distraction osteogenesis in the craniofacial skeleton.

Bone deficiency in the craniofacial skeleton has posed a challenge to craniomaxillofacial surgeons for many decades. Sliding osteotomies and bone grafting have been traditional staples for correcting bone deficiency. In recent years, especially with the advent of newer devices, mechanically induced growth of bone and soft tissue has be-come a major tool in the correction of bony deficiency of the skull and face. In this article, the authors discuss the physiology and technique of distraction osteogenesis, or mechanically induced growth,for the correction of congenital and acquired facial deformities.

Adolescent↗
PubMed2006

Le Fort III osteotomy or distraction osteogenesis imperfecta: your choice.

BACKGROUND: Traditional Le Fort III osteotomies have been described by several authors; however, few have reported the distances advanced and stability over time. METHODS: The authors assessed their last 30 Le Fort III osteotomies with respect to the immediate incisor advancement achieved at surgery and long-term advancement as measured at the A-point from preoperative and postoperative cephalometric tracings. The authors then compared their results with those in the literature for Le Fort III distraction techniques. Comparisons were made with respect to distraction distance maintained, the need for bone grafting, airway results, morbidity, and cost. RESULTS: The mean incisor advancement at the time of surgery as recorded in 14 patients was 21.6 mm (range, 12 to 28 mm). The long-term cephalometric A-point measurements in 14 patients demonstrated a mean of 14.14 mm (range, 8 to 25 mm). CONCLUSION: The authors conclude that, at the present time, no significant improvement in the results using Le Fort III distraction osteogenesis when compared with traditional methods has been shown.

Cephalometry↗
PubMed2005

Maxillary alveolar ridge augmentation using distraction osteogenesis: a literature review and case report.

The restoration of the edentulous atrophic anterior maxillary ridge has proved difficult. The absence of both gingival and bony alveolar tissue contributes to these problems. Numerous techniques to address these issues have been described. We report a case of a patient who sustained multiple facial injuries as a consequence of an accident, including the loss of the maxillary incisor teeth and associated alveolus. This patient underwent fixed implant supported prosthetic rehabilitation, following the use of distraction osteogenesis in the reconstruction of the edentulous atrophic anterior maxillary ridge.

Adult↗
PubMed2006

Expression of nerve growth factor and vascular endothelial growth factor in the inferior alveolar nerve after distraction osteogenesis.

The objective of this study was to evaluate changes occurring in the inferior alveolar nerve (IAN) subsequent to mandibular distraction osteogenesis, with regard to the expression of nerve growth factor (NGF) and vascular endothelial growth factor (VEGF). Unilateral mandibular distractions (0.5mm each, twice per day for 10 days) were conducted on 8 mongrel dogs. Two animals were killed at 7, 14, 28 and 56 days after completion of distraction. The distracted IAN and contralateral control nerve were then harvested and analysed histologically and immunohistochemically. Signs of acute nerve injury, including demyelination, were observed in the distracted IAN on the 7th and 14th day after distraction. At 56 days, the histological features of the distracted IAN were similar to those of the control nerve. The levels of NGF and VEGF expression were significantly elevated on the 7th and 14th day after distraction. NGF was expressed in most of the distracted nerve tissues, but VEGF was primarily detected in Schwann cells and the neurovasorum. VEGF expression had returned to normal but NGF expression was still profoundly elevated 28 days after distraction. NGF expression returned to normal levels at 56 days after distraction. NGF and VEGF appeared to have been elicited from the Schwann cells and damaged nervous tissues, and they may play important roles in the initial healing of damaged nerves. VEGF expression returned to normal more quickly than did NGF expression. This may indicate that hypoxic conditions within the distracted nerve had recovered to normal during the early stages of consolidation. Micro-vessels in the distracted nerve may have recovered more rapidly than did the nerve tissue itself.

Animals↗