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Osteogénesis por distracción en defectos mandibulares y su estabilidad esquelética a los 2 a?os de tratados
Vila Morales,Dadonim; Garmendia Hernández,Georgia; Felipe Garmendia,ángel Mario;
Revista Cubana de Estomatolog?-a , 2011,
Abstract: to show the results of the skeletal stability after 2 years of to be operated on from the first patients presenting with mandibular hypoplasias treated with osteogenic distraction in our country. eleven hemi-mandibles in 7 patients using mandibular osteogenic distraction with leibinger distraction device. latency period was of 72 hours, mandibular distraction was applied at a rate of 1,0 mm each 12 hours and fixation was of 8 weeks. then, postsurgical orthodontic treatment was started. there were significant postoperative skeletal changes. results were assessed by cephalometry studies before intervention, after and at 2 years of treatment. also, there were significant postoperative skeletal changes in snb and anb with p< 0,05. the arithmetic mean of the osteodistraction achieve in branch was of 7,5 mm and in the body it was of 8,0 mm. at 2 years there remain a mandibular bone stability of 88,8 % qualified as good. occlusal changes were favorable. there were not complications involving the good course of patients treated. it was shown that the bone distraction is an effective method for treatment of mandibular defects.
Distraction Osteogenesis in Dentistry
Fernandes,Flávio Henrique Carri?o N; Orsi,Iara Augusta; Bezzon,Osvaldo Luiz;
International Journal of Morphology , 2010, DOI: 10.4067/S0717-95022010000300013
Abstract: distraction osteogenesis is a technique for induction of new bone formation between two segments of a bone that presents wide possibilities of use in dentistry. however, the available information on this subject is still scarce. the aim of this article is to review the literature related to bone formation, mechanically induced by distraction osteogenesis, in order to supply subsidies the agreement of this process.
Distracción osteogénica vertical de injerto microvascularizado de peroné para reconstrucción mandibular y optimización de la rehabilitación implantológica Vertical distraction osteogenesis of microvascularised fibular grafts for mandibular reconstruction and optimisation of rehabilitation implantology
G.Y. Cho Lee,L. Naval Gías,F.J. Rodríguez Campo,M.F. Mu?oz Guerra
Revista Espa?ola de Cirugía Oral y Maxilofacial , 2010,
Abstract: Introducción: En la actualidad, se considera que el injerto microvascularizado de peroné es la mejor opción de tratamiento para las reconstrucciones mandibulares de defectos óseos mayores de 6 cm. No obstante, debido a su limitada altura, presenta una importante desventaja en cuanto a la rehabilitación protésica, particularmente en aquellos casos de resecciones mandibulares parciales con una hemimandíbula contralateral dentada. Material y métodos: Presentamos un caso clínico de mixoma mandibular tratado mediante resección quirúrgica y reconstrucción mandibular primaria mediante injerto microvascularizado de peroné, al que se sometió a distracción osteogénica vertical para optimizar la posterior rehabilitación implantológica. Resultados: La discrepancia de altura se solucionó completamente y se colocaron tres implantes osteointegrados en el área distraída, lo cual permitió una rehabilitación protésica muy satisfactoria, tanto estética como funcionalmente. Conclusiones: La distracción osteogénica vertical de peroné constituye una excelente opción terapéutica para igualar la altura del peroné a la del reborde alveolar de la hemimandíbula dentada contralateral, tras la reconstrucción de defectos mandibulares extensos, de cara a una posterior rehabilitación implantológica, lo que permite llevar a cabo ésta con resultados, tanto funcionales como estéticos, muy satisfactorios. Además, no presenta los inconvenientes de otras técnicas empleadas en estos pacientes, como el peroné en doble barra (mayor dificultad técnica y mayor riesgo de trombosis en el pedículo) y el empleo de injertos "onlay" (morbilidad a adida en la zona de toma del injerto). Introduction: Free vascularized fibular flap is considered the treatment of choice in mandibular reconstruction for extensive bone defects. But, when the reconstruction involves a dentate mandible, the fibula has the limit as it doesn't offer sufficient bone height to restore the alveolar arch up to the occlusal plane. Therefore, the deficiency in bone height makes implant placement impractical. Materials and methods: We report a case of vertical distraction osteogenesis of a free vascularized fibula flap used to reconstruct a hemimandible after resection of an odontogenic myxoma. The distraction device was applied intraorally. Distraction of 0.5 mm per day was performed followed by 3 months of consolidation period. Results: The vertical discrepancy between the fibula and the native hemimandible was corrected. The increase of vertical bone height was stable and enabled placement of dental implants without any complicatio
Alveolar distraction osteogenesis – Crestal widening by distraction osteogenesis
Zvi Laster
Hellenic Archives of Oral and Maxillofacial Surgery , 2010,
Abstract: Following tooth extraction, resorption of the residual ridges occurs in both the vertical and the horizontal directions. Most of this resorption occurs within the first 6 months after tooth extraction. To correc tthis vertical/ horizontal/ dual situation, several surgical approaches have been proposed: autogenous bone grafts, guided bone regeneration, and alveolar distraction osteogenesis (ADO). In recent years, ADO has gained an ongoing popularity ,especially in view of its numerous advantages, mostimportant among them being the shortening of treatment periods and earlier dental implant placement. In cases in which there is sufficient vertical height but not enough bucco-ligual width to accommodate an implant, crestal width has to be built. Crestal widening by distraction osteogenesis is the preferred technique in suchcases. In this study a new type of crest widener, the"Laster" Crest Widening Distractor, is presented, reporting two cases where crest widening by distraction was chosen as the preferred treatment plan. Finally the main advantages and disadvantages of the new crest widening distractor are discussed, helping thus the clinician to make up his mind about this new promising device and surgical technique.
Osteogénesis por distracción esquelética maxilomandibular: Análisis de esta novedosa terapéutica OSTEOGENESIS BY MAXILLOMANDIBULAR SKELETAL DISTRACTION: ANALYSIS OF THIS NOVEL THERAPEUTICS
Dadonim Vila Morales,Georgina Garmendía Hernández
Revista Cubana de Estomatolog?-a , 2005,
Abstract: El proceso de generación de nuevo hueso por estiramiento del callo óseo se denomina osteogénesis por distracción. Este proceso se aplica también a los huesos del macizo craneofacial, y en especial a la mandíbula, para tratar defectos mandibulares que aparecen en diferentes síndromes, como el Treacher Collins, microsomía hemifacial, Pierre Robins, apnea obstructiva del sue o y otras deformidades secundarias a anquilosis de la articulación temporomandibular y traumas. Se realizó una revisión bibliográfica del tema. Nuestro estudio de 45 series publicadas arrojó que el tipo de distractor más usado es el extraoral, que el hueso más tratado es la mandíbula, que solo el 4,4 % de los autores realizan estudios cefalométricos para la evaluación de los resultados y que las complicaciones más frecuentes son la avulsión parcial de los pines, dolor en la ATM y limitación de la apertura bucal. The process of generation of a new bone by lengthening the osteal callus is called osteogenesis by distraction. This process is also applied to bones of the craniofacial skeleton and, specially, to the mandible to treat mandibular defects appearing in different syndromes, such as Treacher Collins, hemifacial microsomy, Pierre Robins, obstructive sleeping apnea, and other deformities secondary to ankylosis of the temporomandibular joint and traumas. A bibliographic review of the topic was made. Our study of 45 series published showed that the extraoral was the most used type of distractor, that the mandible was the most treated bone, that only 4.4 % of the authors conduct cephalometric studies to evaluate the results, and that partial avulsion of the pins, pain in the TMA and limitation to open the mouth were the most frequent complications.
Maxillary Distraction Osteogenesis  [PDF]
Mohammad-Esmaiil Hassani, Hamid Karimi, Hosein Hassani, Ali Hassani
Surgical Science (SS) , 2015, DOI: 10.4236/ss.2015.62003
Abstract:

Background: Distraction Osteogenesis is popular for long bones. And nowadays it has found its role in facial bone deficiency treatments. Purpose: We used our special designed Distractor for advancement of Maxillary deficiencies in cleft lip and palate patients. The purpose of this paper is to compare the treatment of hypoplastic, posteriorly retruded maxillary of cleft palate patients using distraction osteogenesis vs. Le fort I orthognathic surgery for length of advancement, stability and relapse, growth after distraction and soft tissue expansion and soft tissue profile changes. Meterial & Methods: In group A only Le fort I and surgical maxillary advancement sometimes with bone graft were done. In group B we used our special Distractor for Distraction Osteogenesis and advancement of the Maxillary bone. Demographic data, length of retrusion of maxilla, time length of treatment, length of advancement and relapse, SNA and SNB angles were measured and included in the study. The results were compared in each group before and after advancement and between both groups. The rate of distraction was 0.5 mm twice per day to achieve normal occlusion with 2 mm overcorrection more than calculated measures. The devices removed after 10 weeks as latency period. Results: The SNA increased at the end of distraction (p < 0.001), with no significant relapse indicating stability at 1 year after treatment. The total length of advancement in group A was 17 ± 4 mm and in group B was 20 ± 3 mm. The difference between before and after measurements in each group was significant (p = 0.002, p = 0.003 respectively). The mean length of relapse in group A was 3 ± 1 mm and in group B was 1 mm. Discussion: For the deformities and retrusions less than 7 - 8 mm, the Orthognatic surgery is the treatment of choice, however for more retrusions (>10 mm) we recommend Distraction Osteogenesis, and it preferred to start it soon in younger ages.

An investigation on distraction osteogenesis in maxillofacial surgery
Fariaby J
Journal of Dental Medicine , 2003,
Abstract: Distraction osteogenesis (DO), firstly introduced to the medical world by Russian scientist Ilizarov"nfor long bone lenghtening in orthopedics can be considered as an appropriate substitute in the treatment of"nmaxillofacial deformities. Natural events occuring during the repair of a fractured bone segment not only lead"nto the desired bone length but also prevent from the undesired disadvantages of osteotomies and bone"ngrafting. Recently a lot of investigations have been conducted to evaluate the efficacy of DO in the treatment"nof maxillofacial deformities, which in some cases have lead to successful results. In the present article a lot of"nissues in maxillofacial surgery and different treatment goals associated with DO are discussed.
Distraction osteogenesis: a literature review  [PDF]
Fernanda Mara de Paiva BERTOLI,Lílian de Mello GIL,Paula do Nascimento Paiva IZQUIERDO
Perspectives in Oral Sciences , 2010,
Abstract: Distraction osteogenesis (DO) is a surgical-orthodontic technique, described primarily in orthopedic surgery in order to promote long-bone lengthening. This technique results in new bone formation through the lengthening of the bone callus, consisting of a biological process which sets off the bone neoformation after the separation of two bone structures that used to be a single unit. The induced traction generates tension within the callus and stimulates the formation of new bone parallel to the distraction vector. This force also creates tension on the surrounding soft tissues, initiating a sequence of adaptive changes known as distraction histogenesis. DO has been widely used in the treatment of patientswith great craniofacial bone deficiencies. Besides, it can eliminate the need for graft procedures and provide sufficient bone quality and quantity to allow implants and prostheses to be placed and orthodontic movements to be performed. The present study is a literature review that aims to illustrate the historic evolution and the biological principles of DO, describing its clinical applications and what can be expected for future treatments.
External frame distraction osteogenesis of the midface in the cleft patient  [cached]
Hussain Syed
Indian Journal of Plastic Surgery , 2009,
Abstract: Distraction osteogenesis has established itself as an accepted form of treatment in the management of midface deficiency in cleft patients. However, it is well known that some amount of relapse is inevitable in patients who undergo this procedure. Like most surgical techniques, it has its specific indications, limitations, and complications. The problems are amplified in some patients because of severe fibrosis resulting from previous palate and lip operations. This article reviews treatment planning, pre- and postoperative orthodontic management, operative technique, and mechanics of distraction. It also discusses long-term changes following distraction and protocols to optimize the results and minimize complications.
Distraction osteogenesis in the craniofacial complex. I. Mandible, hemifacial microsomia.
P. A. Kyzas,M. Andriotellis,L.-V. Vassiliou,I. Fakitsas
Hellenic Orthodontic Review , 2004,
Abstract: The term distraction osteogenesis describes the technique of new bone production between surgically created osseous segments that are gradually separated, as well as the simultaneous muscular and soft tissue changes occurring as an adjustment to the new morphology of the area under distraction. The aim of this study is to investigate the literature concerning indications and contraindications of distraction osteogenesis, surgical techniques and distraction appliances used. Furthermore, clinical pictures of the application of distraction osteogenesis are presented. The main indications for implementation of distraction osteogenesis in the craniofacial complex are severe deficiencies of the maxilla and mandible, bi- or unilateral, syndrome-related or not. Distraction osteogenesis is absolutely contraindicated, as a method of new bone production, in the treatment of patients with craniofacial dysplasias due to excessive osseous activity. Continuous collaboration between the orthodontist and the maxillofacial surgeon is of outmost importance throughout the process. Part I of this review refers to the basic principles of this technique and the factors concerning the application of distraction osteogenesis for the treatment of mandibular growth anomalies. Mandibular anomalies at the three planes (horizontal, sagittal and vertical) are separately examined and the indications, surgical techniques, distraction appliances, advantages and disadvantages of the method in each case are reported. The issue is also approached from an orthodontic perspective. In conclusion, distraction osteogenesis is a new, developing and much promising technique which, nevertheless, is no panacea; it should therefore be applied only in such cases where it is absolutely indicated.
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