• Title/Summary/Keyword: Distraction osteogenesis

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Midfacial distraction osteogenesis of Crouzon syndrome with RED(Rigid External Distraction) system (RED(Rigid External Distraction) system을 이용한 Crouzon syndrome환자의 distraction osteogenesis)

  • Lee, Yang-Ku;Choi, Jeong-Ho;Kim, Seok-Hwa;Baek, Seung-Hak;Chang, Young-Il
    • The korean journal of orthodontics
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    • v.32 no.3 s.92
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    • pp.175-183
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    • 2002
  • Crouzon syndrome Is one of the craniofacial syndromes characterized by craniosynostosis, midfacial hypolpasia and ocular proptosis. Distraction osteogenesis is becoming Important technique to treat craniofacial dyplaisa. It has nuy advantages compared with standard orthognathic surgery. Maxillary distraction osteogenesis after Le Fort III osteotomy with the RED system presents successful maxillary protraction to Crouzon syndrome patient with severe maxillary deficiency. It also allows remarkable improvement of facial esthetics and respiratory functions.

SONOGRAPHIC CHANGE OF MANDIBULAR DISTRACTION OSTEOGENESIS (하악골 신장술의 초음파적 변화)

  • Kim, Chul-Hwan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.33 no.4
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    • pp.297-306
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    • 2007
  • Distraction osteogenesis was pioneered by Ilizarov in the treatment of injured extremities. Its subsequent application to Oral and Maxillofacial Surgery has opened a new chapter in the treatment of facial deformity. Careful monitoring of the period of distraction and consolidation of the callus is important and has been well described. Complications, such as infection, haematoma and premature ossification, are difficult to diagnose and can compromise the outcome after the surgery. Too slow rate of distraction results in premature fusion of cortices and too rapid information of bone 'cyst' within the callus distraction. I experienced 2 patients of congenital unilateral mandibular hypoplasia, so called Hemifacial Microsomia. After distraction surgery, I evaluated callus formation of mandibular distraction with Ultrasound Sonography during distraction and consolidation period. Plain radiography, although it enables accurate measurement of the distraction gap, did not give sufficient detail to allow assessment of early stages of bone formation, But, ultrasound monitoring could enable continuous monitoring of the distraction gap without exposure to ionizing radiation and allow detection of fine detail, which may influence manipulation of the callus.

Management of obstructive sleep apnea in a Treacher Collins syndrome patient using distraction osteogenesis of the mandible

  • Damlar, Ibrahim;Altan, Ahmet;Turgay, Berk;Kilic, Soydan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.42 no.6
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    • pp.388-392
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    • 2016
  • In this study, we present the surgical treatment of obstructive sleep apnea in a child with Treacher Collins syndrome. A 10-year-old girl with a past history of Treacher Collins syndrome presented to our clinic with her parents for respiratory distress and insomnia. The patient was referred to a sleep laboratory where she was diagnosed with obstructive sleep apnea, which was a consequence of her Treacher Collins syndrome. The patient underwent mandibular distraction osteogenesis under general anesthesia. The mandible was expanded by 15 mm using internal bilateral distractors. After distraction osteogenesis, the patient's respiratory problems resolved, and she was able to sleep comfortably. Distraction osteogenesis was an effective method of advancing the mandible, increasing the upper airway space and ultimately preventing obstructive sleep apnea syndrome in patients with Treacher Collins syndrome.

Treatment of Brachymetatarsia by Distraction Osteogenesis (중족골 단축증의 신연 골형성술 치료)

  • Oh, Hyun-Chul;Lee, Yun-Tae;Ha, Joong-Won;Park, Yung;Choi, Yun-Jin
    • Journal of Korean Foot and Ankle Society
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    • v.9 no.1
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    • pp.42-46
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    • 2005
  • Purpose: To evaluate the efficacy of distraction osteogenesis for fourth brachymetatarsia. Materials and Methods: Seven patients (10 cases) who were treated by distraction osteogenesis for fourth brachymetatarsia from March 2000 to December 2003 were reviewed retrospectively. Results: The average length gain of fourth metatarsus was 16.6 mm (37%) and the average healing index was 50 days/cm. The final results according to AOFAS functional scale were excellent in 8 cases and good in 2 cases. Conclusion: Distraction osteogenesis is an effective treatment for fourth brachymetatarsia in spite of some minor complications.

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Distraction osteogenesis in collapsed mandible arch patients by accidents (사고에 의해 하악골 폭경이 붕괴된 환자에서 견인골 신장술)

  • Tae, Ki-Chul;Kang, Kyung-Hwa
    • The korean journal of orthodontics
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    • v.33 no.2 s.97
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    • pp.85-90
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    • 2003
  • The symphyseal mandibular fractures due to accidents happened in form of collapsed transeverse arch and multiple teeth loss. And the collapsed transverse arch in mandible occurs with unilaterally or bilaterally. So that patient needs to recover arch width. Conventional approaches, however, we difficult to get appropriate transverse arch correction. Distraction osteogenesis is a unique form of clinical tissue engineering and biologic process of new bone formation between bone segments that are gradually separately by incremental traction. Distraction osteogenesis is considered that great potential for correcting transverse mandibular deficiencies. Tn this paper, distraction osteogenesis applied to patients who had a unilateral or bilateral collapsed arch width in mandible. But it was necessary secrutinize consideration about periodontal conditions, biomechanical vectors, TMJ adaptations, and neuromuscular change during distraction osteogenesis period.

Correction of a Wide Alveolar Cleft with Reverse L osteotomy and Liou Alveolar Distractor (역 L 형 절골술과 Liou 신연기를 이용한 넓은 치조열의 교정)

  • Lee, Myung Chul;Lew, Dae Hyun;Park, Beyoung Yun;Kwon, Soon Man
    • Archives of Plastic Surgery
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    • v.36 no.4
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    • pp.445-449
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    • 2009
  • Purpose: A successful surgical treatment for a wide alveolar cleft with bone graft is difficult to achieve due to several factors such as the limitation of gingivoperiosteal flap, the presence of large scar tissues, and the poor blood circulation. To overcome these problems, alveolar distraction osteogenesis using Liou alveolar distraction device was applied. We analyzed the consequences of this surgical treatment. Method: Between 2006 January and 2007 August, we have conducted analysis on the methods and consequences of Liou alveolar distraction osteogenesis for 6 patients. The age of patients was 12 years and 6 months in average. The follow up period was 19 months in average. The Reverse L osteotomy followed by the placement of the Liou alveolar distraction device was performed. After serial distraction, the distractor was removed after 5 months of the process of osteogenesis, and the result was analyzed using the computed tomography and the x-ray films of the alveolar bone and the teeth. Results: The alveolar cleft with 12.5 mm in average width was filled with 8.5 mm of newly formed bone tissue in average width after 5 months of osteogenesis. Among the 6 cases, 5 required the additional bone graft and 1 case only required the gingivoperioplasty. The newly formed bone tissues did not show any signs of bone resorption. However, a considerable degree of teeth displacement was shown. Conclusion: For the alveolar cleft too wide to be reconstructed by a general bone graft, it is strongly recommended to perform the reverse L osteotomy of the cleft side with Liou alveolar distraction device to initiate the alveolar osteogenesis. However, the migrated teeth showed some degree of relapse, thus, the orthodontic treatment is essential following the distraction osteogenesis treatment.

HISTOLOGICAL CHANGES AND EXPRESSION OF NERVE GROWTH FACTOR IN THE INFERIOR ALVEOLAR NERVE AFTER DISTRACTION OSTEOGENESIS (하악골 신장술 후 하치조신경의 조직학적 변화와 신경성장인자의 발현에 대한 연구)

  • Park, Bong-Wook;Kim, Jong-Ryoul;Byun, June-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.27 no.5
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    • pp.415-423
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    • 2005
  • Distraction osteogenesis (DO) is frequently used technique in reconstruction of bony defects resulted from tumor resection, congenital deformity, and trauma in the maxillofacial region. Although the histologic and ultrastructural changes associated with distraction osteogenesis have been extensively described, the exact changing of the surrounding tissues, such as nerve tissues, were still unclear. This study observed the histological changes and the expression of nerve growth factor (NGF) in the inferior alveolar nerve (IAN) after distraction osteogenesis. Unilateral mandibular distraction (0.5 mm twice per day for 10 days) was performed in eight mongrel dogs. Two animals were sacrificed at 7, 14, 28 and 56 days after completion of distraction, respectively. The distracted IAN and contralateral control nerve were harvested and processed for histological and innunohistochemical examinations. The signs of acute nerve injuries, such as demyelination and partial discontinuation of nerver fiber, were observed in the distracted IAN on 7 and 14 days after distraction. The initial remyelination and regeneration of distracted IAN were showed at 14 days after completion of distraction. At 56 days later, the histologic features of distracted IAN was similar to those of the normal control IAN. The expression of NGF was significantly increased in most distracted nerve tissues on 7, 14 and 28 days after distraction. On 56 days after distraction, the expression of NGF returned to the normal level. This study suggested that the acute IAN injury caused by mandibular distraction were mostly recovered during consolidation period. The NGF was seemed to be induced from Schwann cell and damaged nerve tissues, and it may have important roles in the initial healing of damaged nerves.

Growth observation and orthodontic treatment of a hemifacial microsomia patient treated with distraction osteogenesis

  • Chung, Nam Hyung;Yang, So Jin;Kang, Jae Yoen;Jeon, Young-Mi;Kim, Jong Ghee
    • The korean journal of orthodontics
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    • v.50 no.2
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    • pp.136-144
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    • 2020
  • Hemifacial microsomia (HFM) patients may experience emotional withdrawal during their growth period due to their abnormal facial appearance. Distraction osteogenesis at an early age to improve their appearance can encourage these patients. Some abnormalities of the affected side can be overcome by distraction osteogenesis at an early age. However, differences in the growth rate between the affected and unaffected sides during the rest of the growth period are inevitable due to the characteristics of HFM. Therefore, re-evaluation should be performed after completion of growth in order to achieve stable occlusion through either orthognathic surgery or camouflage orthodontic treatment. An eight-year-old patient visited the clinic exhibiting features of HFM with slight mandibular involvement. He received phase I treatment with distraction osteogenesis and a functional appliance. Distraction osteogenesis was performed at the right ramus, which resulted in an open bite at the right posterior dentition. After distraction osteogenesis, a functional appliance and partial fixed appliance were used to achieve extrusion of the affected posterior dentition and settlement of the occlusion adjustment on the unaffected posterior dentition. The patient visited the clinic regularly for follow-up assessments, and at the age of 20 years, he showed facial asymmetry of the mandible, which had deviated to the right side. He received orthodontic treatment to improve the occlusion of his posterior dentition after the growth period. Without orthognathic surgery, stable occlusion and a satisfactory facial appearance were obtained through camouflage orthodontic treatment.

Distraction osteogenesis in facial asymmetry patient (견인골 신장술을 이용한 안모 비대칭 환자 치험례)

  • Tae, Ki-Chul;Kang, Kyung-Hwa;Lee, Su-Haeng;You, Seck-Keen
    • The korean journal of orthodontics
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    • v.33 no.5 s.100
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    • pp.391-398
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    • 2003
  • Distraction osteogenesis is a well-estabilished procedure of membraneous bone formation and has been used to correct craniofacial deformities in dentofacial orthopedic-surgery area for decades. In this articale, distraction osteogenesis is used for treatment of facial asymmetry. The patient underwent procedures to lengthen the mandibular ramus and body. After distraction, orthodontic treatment was done for ooclusal settling.

DISTRACTION OSTEOGENESIS ON MANDIBLE SYMPHYSIS WIDENING WITH A BONE-BORNE TYPE DISTRACTOR (Bone-borne type distractor를 사용한 하악골 정중부 골신장술)

  • Cho, Jin-Hyoung;Chee, Young-Deok
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.28 no.4
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    • pp.356-364
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    • 2006
  • Transverse mandibular deficiency has a many problem in growing patients. Therefore, Mandible symphysis widening is recommended. A new surgical technique has been developed to widen the mandible. The purpose of this study is to report the effect of mandibluar symphyseal distraction osteogenesis by use of bone-borne type distractor. The surgical procedure was accomplished under general anaesthesia with step-line osteotomy. Bone-borne type distractor was used to generally widen the mandible. The expansion achieved in the mandible was 8.31mm at the device, 6.32mm at the canines, 4.06mm at the first molars. The symphyseal distraction gaps were bridged by new bony regeneration. Mandibular symphseal distraction osteogenesis increased mandibular arch width, stabilized occlusion, and corrected dental crowding.