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PubMed1976

[Pathohistological study on the effect of various methods of osteosynthesis on the osteogenesis in experimental fracture of the lower jaw].

The lower jaw of 60 dogs was fractured and effects of wire and three variants of chemical osteosynthesis have been followed up concerning validity, course and rapidity of osteogenesis. A wire of 0.4 mm in the diameter was applied in wire osteosynthesis and autopolymerizing acryalte ("Simplex" Galenica) in chemical osteosynthesis with briding of the fracture line interfragmentarily or mixed with bone scrapings. The pathohistological examinations performed 7, 14, 21, 60 and 90 days after the intervention and osteosynthesis employment have shown that there is no difference in validity, course and rapidity of osteogenesis in fractures of the lower jaw under conditions of wire and pure chemical osteosynthesis. Since there is no histochemical obstacles and taking into account advantages of chemical over wire osteosynthesis it should be recommended in fractures of the lower jaw.

Animals↗
PubMed2000

Precise cannulation of the foramen ovale in trigeminal neuralgia complicating osteogenesis imperfecta with basilar invagination: technical case report.

OBJECTIVE AND IMPORTANCE: Trigeminal neuralgia is a rare feature of basilar invagination, which is itself a complication of osteochondrodysplastic disorders. Microvascular decompression is an unattractive option in medically refractory cases. The conventional percutaneous approach to the trigeminal ganglion is anatomically impossible because the foramen ovale points inferiorly and posteromedially. We report a new technique for image-guided trigeminal injection in a patient with basilar invagination complicating osteogenesis imperfecta. CLINICAL PRESENTATION: A 26-year-old woman with osteogenesis imperfecta presented with a 3-year history of typical left maxillary division trigeminal neuralgia, which was poorly controlled by carbamazepine at the maximum tolerated dose. She had obvious cranial deformities, left optic atrophy, delayed left eye closure, tongue atrophy, but normal facial sensation and corneal reflexes. A computed tomographic scan and magnetic resonance imaging confirmed severe basilar invagination. TECHNIQUE: Frameless stereotactic glycerol injection of the left trigeminal ganglion was performed under general anesthesia using the infrared-based EasyGuide Neuro system (Philips Medical Systems, Best, The Netherlands) with magnetic resonance imaging and computed tomographic registration. The displaced and distorted left foramen ovale was cannulated via a true frameless stereotactic method with the trajectory determined by virtual pointer elongation. The needle placement was confirmed with injection of contrast medium into the trigeminal cistern. The path needed to enter the foramen traversed the right cheek, soft palate, and left tonsil. The patient went home pain-free with a preserved corneal reflex and no complications. CONCLUSION: Frameless stereotaxy allows customization to individual patient anatomy and may be adapted to a variety of percutaneous procedures used in areas where the anatomy is complex.

Adult↗
PubMed1999

[Prenatal diagnosis of osteogenesis imperfecta. Report of a case].

Osteogenesis imperfecta is a heterogeneous group of connective tissue disorders; it is characterized by blue scleras, bone fragility and deformity secondary to recurring fractures. A case of osteogenesis imperfecta personally observed at the 21st week of gestation is presented.

Adult↗
PubMed1999

Distraction osteogenesis of the midface: a new implantable distraction device.

This report describes the use of a new implantable device for distraction osteogenesis of the maxilla in treatment of midface hypoplasia seen in craniofacial syndromes. The technique of distraction osteogenesis is a recent advance in plastic surgery for treatment of bone growth disorders. The device is totally implantable except for the activating pin and can provide up to 30 mm of total advancement. We will describe our surgical technique and distraction protocol, illustrated by a case report of the device successfully used in a child with Crouzon syndrome.

Child↗
PubMed2000

[Distraction osteogenesis of the mandible in 2 children with obstruction of the upper respiratory tract due to micrognathia].

A girl approximately 2 years old with Pierre Robin sequence had periods of nocturnal respiratory insufficiency as a consequence of micrognathia and a boy nearly 4 years old with Nager syndrome and tracheostomy was retarded in his speech development, had problems swallowing and often had respiratory tract infections. The obstruction of the upper respiratory tract was resolved by performing a distraction osteogenesis of the lower jaw. A tracheostomy was avoided or else removed. The girl became more active and there was an improvement in the boy's speech development. Distraction osteogenesis is a good alternative to the current practice of mandibular reconstruction in micrognathic patients, which involves extensive bone grafts.

Child, Preschool↗
PubMed2000

[Distraction osteogenesis--a new therapeutic principle in complex craniofacial synostosis].

BACKGROUND: Surgical treatment of syndromal craniofacial synostosis consists of combined neurosurgical and maxillofacial reconstructions of the neurocranium and midface. Patients often need several operations if they are to achieve a functionally and cosmetically good result. This is, in part, due to limitations in the amount of "acute" correction possible peroperatively with conventional surgical technique. MATERIAL AND METHODS: In recent years, a new method called distraction osteogenesis has been developed, by which the skeletal elements are gradually advanced. The method is based upon a process whereby the reparative callus formed between the surfaces of two bone segments is subjected to traction. This leads to new bone formation parallel to the vector of distraction. RESULTS: Distraction osteogenesis allows for greater mobilizations, hence the promise of fewer reoperations. INTERPRETATION: The method seems to be a valuable treatment modality in syndromal craniofacial synostosis, where major fronto-orbital, midface or maxillary reconstructions are often called for.

Craniofacial Dysostosis↗
PubMedDate not supplied

Application of capacitively coupled electric field enhances periimplant osteogenesis in the dog mandible.

PURPOSE: Expeditious postoperative ingrowth of bone into dental implants is desired for clinically successful fixation of oral implants. The present study was performed to evaluate the effect of applying a capacitively coupled electric field (CCEF) on periimplant osteogenesis in the dog mandible. MATERIALS AND METHODS: Twelve adult male beagles were used in this study. All of the premolars on both sides of the mandible were removed from each dog. A POI (Ti-6Al-4V) 3-piece implant (3.7 mm in diameter and 8.0 mm in length) whose surface had been treated with anodic oxidation was placed into each test site by self-tapping. Daily application of CCEF (8 h/day) was initiated on the day following the surgery and was continued through the day of sacrifice. A CCEF was induced by an external source delivering 10-Vp-p, 60-kHz sine-wave signals through an oral electrode plate. One side of the mandible of each dog was treated with CCEF, while the other side was not. On the control side, an oral electrode plate was attached for 8 hours per day, but CCEF was not applied. The effect of daily application of CCEF on the ingrowth of bone into the implant was examined at 14, 21, or 30 days after implant placement. A fourth control group was not treated with CCEF and was maintained for 90 days to confirm that CCEF treatment enhances bone ingrowth in dental implants. RESULTS: Daily application of CCEF significantly increased the bone-contact ratio at days 14, 21, and 30 after implant placement in comparison with the respective controls. The bone-area ratios of the 14- and 21-day CCEF-treated groups were significantly larger than those of the respective controls and were similar to those of the 90-day control group. CONCLUSION: CCEF treatment increases periimplant osteogenesis in the dog mandible, confirming its usefulness in oral implantology.

Alloys↗
PubMedDate not supplied

Vertical distraction osteogenesis of edentulous ridges for improvement of oral implant positioning: a clinical report of preliminary results.

This study examined the opportunities offered by intraoral distraction osteogenesis to vertically elongate insufficient alveolar ridges and thereby improve local anatomy for ideal implant placement. Eight patients presenting with vertically deficient edentulous ridges were treated by means of the distraction osteogenesis principle with an intraoral alveolar distractor. Two to 3 months after consolidation of the distracted segments, 26 implants were placed in the distracted areas. Four to 6 months later, abutments were connected and prosthetic loading of the implants was started. The mean follow-up after initial prosthetic loading was 14 months. In all patients, the desired bone gain was reached at the end of distraction (mean vertical bone gain of 8.5 mm). Probing depth, Bleeding Index, and Plaque Index around implants were evaluated, and Periotest values were also calculated. The cumulative success rate of implants was 100%. Radiographic examinations 12 months after functional loading of implants showed a significant increase in the density of the newly generated bone in the distracted areas. This technique seems to be reliable, and the regenerated bone has withstood the functional demands of implant loading. Success rates of implants, periodontal indices of peri-implant soft tissues, and Periotest values were consistent with those reported in the literature regarding implants placed in native bone.

Adult↗
PubMed2000

[Distraction osteogenesis in maxillofacial surgery].

With distraction osteogenesis (DOG) formation of new bone is initiated by gradual separation of osteotomized bone fragments. Both external and internal distraction devices are available. Since its first application in craniomaxillofacial surgery in the early nineties, developments in distraction osteogenesis have been tremendous. Important advantages of this technique are: lack of a donorsite and its associated morbidity; increase of the volume of the soft tissue envelop; less surgical trauma compared to conventional craniomaxillofacial procedures; and the usability of the technique in growing individuals. Disadvantages of DOG are: the sofar limited experience and follow-up in craniomaxillofacial surgery; and the unknown influences on growth. The technique will gradually find its niche and the general dentist will therefore be increasingly confronted with its specific indications. In this paper the general principles of DOG and a number of indications in craniomaxillofacial surgery are discussed.

Humans↗
PubMedDate not supplied

Rod diameter prediction in patients with osteogenesis imperfecta undergoing primary osteotomy.

SUMMARY: Because the cross-sectional shape of the long bones of patients with osteogenesis imperfecta is often elliptical, the use of preoperative radiographs to determine intramedullary rod diameter in these patients undergoing osteotomy may be misleading. To investigate this, the authors correlated the narrowest inner bone diameter (NID) on preoperative radiographs to the rod diameter (RD) on postoperative radiographs. The authors evaluated 79 bones in 27 patients undergoing primary osteotomy with intramedullary fixation. Only 5% of the bones had an equal NID and RD, with 81% of bones having a smaller RD than the measured NID. Although a positive correlation was found between RD and NID (correlation coefficient 0.76), measurement of the NID on preoperative radiographs did not provide a good prediction of the actual RD used in this series of children with osteogenesis imperfecta.

Adolescent↗
PubMed2001

[Vertical alveolar ridge augmentation using distraction osteogenesis].

Alveolar ridge atrophy can be acquired or congenital. Alveolar ridge augmentation can be performed using bone grafting but a donor site morbidity is unavoidable and some resorption of the grafted bone occurs. Distraction osteogenesis offers an alternative method for bone reconstruction without donor site morbidity and sufficient stability of the final results. In order to place implants, vertical alveolar augmentation using Distraction Osteogenesis has been applied to 14 patients aged 17 to 55 years old with edentulous alveolar ridge, 8 in the mandible and 6 in the maxilla. Vertical alveolar bone distraction was started by performing a segmental alveolar osteotomy followed by insertion of a central distraction device--Lead System (Endosseous alveolar distraction system, Leibinger). After three days of latency period, the distraction was started in a rate of 0.8 mm per day for 9 to 16 days as needed. The retention period for the new bone maturation was twice as long as the active distraction period. After removal of the device, 23 cylindrical threaded implants were inserted. The results revealed increase of the alveolar bone height with new bone formation that was observed radiographically and clinically at the removal of the distraction device. The amount of elevation was 7-13 mm. In follow-up of 6-14 months, failure of only one implant was noted, due to inadequate transported bone stability. The advantages of alveolar bone distraction are: Increase of the alveolar bone height with new bone formation, minimal resorption of bone without the bone graft disadvantages. A long term follow up after the bone height achieved and implant anchorage should be performed in the future.

Adolescent↗
PubMed2001

Cardiac reoperation in a patient with osteogenesis imperfecta: a case report.

A case of a 40-year-old man with dehiscence of the prosthetic aortic valve and recurrence of mycotic aneurysm of the left ventricular outflow tract with osteogenesis imperfecta is presented. He had an operation of aortic valve replacement and direct closure of the mycotic aneurysm for infective endocarditis twenty-one months ago. We performed reoperation of prosthetic aortic valve, patch closure of the mycotic aneurysm and graft replacement of the ascending aorta. He was complicated with multiple fractures of bilateral scapla and dislocation of left shoulder one postoperative day. Fortunately, cardiac reoperation was performed successfully in this patient despite anticipated difficulties with tissue friability with osteogenesis imperfecta.

Adult↗
PubMed2000

Paediatric sleep apnoea and treatment with distraction osteogenesis.

Paediatric obstructive sleep apnoea (OSA) associated with craniofacial anomalies frequently is refractory to traditional treatment modalities. Skeletal expansion using distraction osteogenesis to correct facial deformities has proven to be an excellent treatment modality for the resolution of OSA. This paper discusses the use of distraction osteogenesis from infancy through adolescence and will show objective improvement in not only facial norms but also in OSA indices.

Adolescent↗
PubMed2001

[Experimental study of in osteogenesis in duced by NIH-3T3 cells transfected with bone morphogenetic protein 3 gene].

OBJECTIVE: To investigate the gene expression, protein synthesis and inducing osteogenetic capacity of NIH-3T3 cells transfected with recombinant human bone morphogenetic protein 3 (rhBMP3) gene. METHODS: Gene recombination technique was used to clone the BMP3 cDNA into PcDNA3 vector directly, and to form a recombined BMP3-PcDNA3 cDNA, which was introduced into NIH-3T3 cells by means of lipofectamine transfer. The total RNA of transfected NIH-3T3 cells was then extracted to verify the mRNA expression of BMP3 using Northern blot method. BMP3 protein synthesis and AKP activity in the transfected cells was checked. Then, the NIH-3T3 cells transfected with BMP3 gene were injected into nude mouse muscle to evaluate the inducing osteogenesis in the muscle. RESULTS: BMP3 gene had been inserted into PcDNA3 vector successfully. There was BMP3 mRNA expression in the total RNA of NIH-3T3 cells with the peak level appearing in the 6th week after transfection, and BMP3 protein was found in NIH-3T3 cells, and the AKP level is much higher in the transfected NIH-3T3 cells than in non-transfected NIH-3T3 cells. Histologic examination revealed that there were a large number of chondrocytes and trabeculae seen in the nude mouse muscle 4 weeks after injection of the transfected NIH-3T3 cells. CONCLUSION: BMP3 is a protein that possesses osteogenetic effect. After transfection with BMP3-PCDNA3, BMP3 mRNA expression and protein formation can be found in NIH-3T3 cells, and the transfected NIH-3T3 cells have the effect of inducing osteogenesis in vivo.

3T3 Cells↗
PubMed2000

[Intraoral distraction osteogenesis].

OBJECTIVE: To study the application of intraoral distraction osteogenesis in correction of various dentofacial deformities. METHODS: From 1997, 12 cases with various dentofacial deformities were corrected by using 6 kind of intraoral distractor. 3 cases of them were the patients with cleft palate who have severe secondary maxillary hypoplasia. 4 cases with hemifacial microsomia, 2 cases with micrognathia and 3 cases with partial mandibular defect. The maxillae were elongated from 10 mm to 15 mm, the mandibles were elongated from 15 mm to 25 mm, the vertical mandibular distraction was from 10-15 mm. RESULTS: All cases were corrected satisfactorily and have no any complications. In 1 case the distractor did not work during distraction and was replaced. Another case the mandibular margin fractured after distraction, the rigid fixation was performed for it. CONCLUSIONS: The intraoral distraction osteogenesis provides a new method with many advantages for those dentofacial deformities that are difficult correct by using ordinary orthognathic surgery.

Adolescent↗
PubMed2001

[Application of distraction osteogenesis in correction of hemifacial microsomia].

OBJECTIVE: To study the effect of distraction osteogenesis of mandibular ramus in correcting hemifacial microsomia. METHODS: From December 1997 to March 2000 two kinds of mandibular distractors made in Germany and China were used in 11 cases with hemifacial microsomia aged 4.5 approximately 23 years (on average 14.1 years). Orthodontic treatment was given during the distraction. LeFort I osteotomy and genioplasty were performed in 5 cases and 4 cases respectively. RESULTS: The treated mandibular rami were lengthened 15 approximately 30 mm. No infection and dysosteogenesis was found. In only one case, the distractor failed to function at the third day of treatment and was replaced. The distractor was removed after 3 months while new bone was formed in all cases. All of the patients and their family members expressed their satisfaction with the results of treatment. CONCLUSION: Mandibular distraction osteogenesis is the most effective procedure for correcting hemifacial microsomia.

Adolescent↗
PubMed2002

Aortic valve replacement in a woman with osteogenesis imperfecta.

The mortality rate in cardiac surgery patients with heritable generalized connective tissue disorders, such as Marfan s syndrome and osteogenesis imperfecta, is high due to tissue friability. We describe a successful open heart surgery for repair of aortic regurgitation in a woman with osteogenesis imperfecta (OI). Although tissue friability caused no problems during surgery in this case, it should be kept in mind when operating on patients with OI.

Aortic Valve↗
PubMed2002

[Distraction osteogenesis for repair of cleft palate: an experimental study].

OBJECTIVE: To observe the repair of cleft palate (CP) bone defect under the application of distraction osteogenesis (DO); to investigate the correction mechanism in thin bone of palatal shelf and to search a possible new treatment approach for repair of CP. METHODS: 14 cats were assigned randomly to 3 groups: (1) Empty control, 2 cats unoperated with euthanasia at the end of 2 weeks; (2) Experimental control, 2 cats underwent 8 mm x 18 mm palatal osteoectomy in saggital direction as the experimental model of CP with euthanasia in 6 weeks; (3) Experimental group, 10 cats were performed the same palatal osteoectomy as group (2), the newly designed and individual manufactured intraoral distractors were fixed to teeth by brackets and to bilateral palate bone across the defect with titanium miniscrews. 4 weeks later the transport disc (TD) osteotomy were performed and gradual distraction was started after 6 days latency period at the rate of 0.4 mm x 2/day till the TD reached the opposite edge of the CP. Roentgenographic, gross meterage and ultrastructural observation were performed 2, 4, 6, 8, 12 weeks after completion of distraction. RESULTS: All the examinations revealed the TD recombination to the opposite bone edge of the CP, simultaneously, the proportional expansion of overlay mucoperiosteal flap was achieved. The bone defect were filled with de move osteogenesis. Roentgenographically, the new bone mineralization was along the DO vector, developed from the bone cut edges bilaterally to the central translucent zone until turned to thin fissure. Comparison of the plaster casts showed no change in the occlusion or dentomaxillofacial framework. CONCLUSIONS: The intraoral distractor is able to get both effective distraction and steady fixation. The examination results suggest that the CP bone and soft tissue defect could be repaired and acheived functional reconstruction under DO, which could be a new treatment approach for repair of CP.

Animals↗