• Maxillofacial Plastic and Reconstructive Surgery
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• v.28 no.3
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• pp.242-246
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• 2006

Objective : This is to report the criteria of success of intraoral distraction osteogenesis for alveolar augmentation in the severely atrophied alveolar defects through clinical result of 2 cases. Subjects and Methods : Anterior segmental osteotomy was performed and alveolar distractors (Martin and Leibinger, Germany) were applied each in 2 patients with severely defected anterior maxillary area. The osteomized alveolar segments were distracted by 1mm a day after latency period. After the consolidation period implants were installed with removal of distractor. The implants were evaluated clinically and radiographically. Results : In Case I, the distracted bone was directed to the palatal side, and another augmentation treatment - block bone graft, guided bone regeneration - was needed. In Case II, the successful alveolar bone augmentation was achieved. Dental implant was placed on distracted alveolar bone, and showed good osseointegration and good function without any complication. Conclusion : Distraction osteogenesis can be a good choice for alveolar ridge augmentation of severely atrophied ridges. However, the anterior esthetic prosthetics relies on the control of the vector, the kind of distractor, the healing capacity of patient and the etiology of atrophy. Therefore another study of each category would be needed.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.37 no.6
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• pp.539-544
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• 2011

Maxillary canting and vertical shortening of the unilateral mandibular ramus height is common in cases of severe facial asymmetry. Normally, mandibular distraction osteogenesis (DO) with horizontal osteotomy at the ascending ramus is used for vertical lengthening of the mandibular ramus to correct facial asymmetry with an absolute shortened ascending ramus. In this case report, vertical lengthening of the ascending ramus was performed successfully with unilateral DO and sagittal split ramus osteotomy (SSRO), where the posterior part of the distal segment can be distracted simultaneously in an inferior direction with maxillary DO, resulting in a lengthening of the medial pterygoid muscle. This case describes the acquired unilateral mandibular hypoplasia caused by a condylar fracture at an early age, which resulted in abnormal mandibular development that ultimately caused severe facial trismus. The treatment of this case included two-stage surgery consisting of bimaxillary distraction osteogenesis for gradual lengthening of the unilateral facial height followed by secondary orthognathic surgery to correct the transverse asymmetry. At the one year follow-up after SSRO, the vertical length was maintained without complications.

• 대한치과교정학회:학술대회논문집
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• 1999.11a
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• pp.38.3-39
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• 1999

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.5
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• pp.447-453
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• 2010

The hemifacial microsomia is characterized by variable underdevelopment of the craniofacial skeleton, external ear, and facial soft tissues. So, patients with hemifacial microsomia have an occlusal plane canting and malocclusion with facial asymmetry. Distraction osteogenesis (DO) with an intraoral or extraoral device is a technique using tension to generate new bone with gradual bone movement and remodeling. DO has especially been used to correct craniofacial deformities such as a hemifacial microsomia, facial asymmetry, and mandible defect that could not adequately be treated by conventional reconstruction with osteotomies. It has a significant advantage to lengthen soft and hard tissue of underdeveloped site without bone graft and a few complication such as nerve injury or muscle contracture. A 13-years old girl visited our clinic for the chief complaint of facial asymmetry. She had a left hypoplastic maxilla and mandible, occlusal plane canting and malocclusion. We diagnosed hemifacial microsomia and lanned DO to lengthen the affected side. Le Fort I osteotomy, left mandibular ramus and symphysis osteotomy were performed. The internal distraction devices fixed with screw on maxillary and mandibular ramus osteotomy sites. External devices were adapted to lower jaw for DO on symphysis osteotomy site and to upper jaw for rapid maxillary expansion (RME). At 7days after surgery, distraction was started at the rate of 1mm per day for 13days, and after 4months consolidation periods, distraction devices were removed. Simultaneous multiple maxillo-mandibular distraction osteogenesis with RME resulted in a satisfactory success in correcting facial asymmetry as well as occlusal plane canting for our hemifacial microsomia.

• Korean Journal of Cleft Lip And Palate
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• v.7 no.1
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• pp.63-76
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• 2004

Cleft lip and palate(CLP) patients usually have midface deficiency and Class III malocclusion. Distraction osteogenesis (DO) has been used recently to correct the maxillary hypoplasia with stable and predictable result. Both external and internal devices that permit midface distraction are available, This case report describes intraoral DO for correction of the midface deficiency in a adult CLP patient with relapse following orthognathic surgery. The purpose of this report is to present advantages of the intraoral DO for the treatment of CLP, The relative and potential clinical indications, treatment planning, patient preparation, and possible vector control for DO are discussed.

• Korean Journal of Cleft Lip And Palate
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• v.11 no.1
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• pp.37-48
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• 2008

Cleft lip and palate patients often develop maxillary retrusion due to the combined effects of the congenital deformity and the scar tissue after surgical repairs. Maxillary protraction in the cleft patients using orthopedic appliances (i.e. face mask) or distraction osteogenesis during early childhood helps to achieve more balanced skeletal harmony and favorable occlusion for future growth to occur. Kinds, indication, protocol for use of the traditional orthopedic appliances will be discussed. Also the facemask with miniplate system recently developed will be introduced.

• The korean journal of orthodontics
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• v.39 no.3
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• pp.185-198
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• 2009

Tooth anklylosis is defined as the adhesion state of alveolar bone to dentin or cementum. Trauma, disturbed metabolic disease, and congenital disease have been given as etiologic factors. Complications of tooth ankylosis are tipping of the neighboring teeth, space loss, and supraeruption of the opposing teeth. Particularly if dental ankylosis occurs in maxillary incisors of a growing child, the ankylosed tooth can not move vertically with subsequent disturbance in vertical growth of the alveolar process. With an appropriate treatment approach, an esthetic condition must be achieved especially in the maxillary anterior region. In this report, two cases are presented which were treated by the surgical repositioning method. One is treated by alveolar bone distraction osteogenesis which used a tooth-borne type distraction device and the other by single tooth osteotomy.

• The korean journal of orthodontics
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• v.48 no.2
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• pp.113-124
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• 2018

The purpose of this case report was to introduce the concept of orthodontic and orthopedic treatment for a growing patient with Tessier number 0 cleft. A 5-year-old boy patient with Tessier number 0 cleft presented congenitally missing maxillary central incisors (MXCI), a bony defect at the premaxilla, a constricted maxillary arch, an anterior openbite, and maxillary hypoplasia. His treatment was divided into three stages: management of the bony defect at the premaxilla and the congenitally missing MXCIs using a fan-type expansion plate, iliac bone grafting, and eruption guidance of the maxillary lateral incisors into the graft area for substitution of MXCIs; management of the maxillary hypoplasia using sequential facemask therapy with conventional and skeletal anchorage; and management of the remaining occlusal problems using fixed orthodontic treatment. The total treatment duration was 15 years and 10 months. Class I canine and Class II molar relationships and normal overbite and overjet were achieved at the end of treatment. Although the long-term use of facemask therapy resulted in significant protraction of the retrusive maxilla, the patient exhibited Class III profile because of continued mandibular growth. However, the treatment result was well maintained after 2 years of retention. The findings from this case suggest that interdisciplinary and customized approaches are mandatory for successful management of maxillary hypoplasia, bony defect, and dental problems in Tessier number 0 cleft. Moreover, considering the potential of orthognathic surgery or distraction osteogenesis, meticulous monitoring of mandibular growth until growth completion is important.

• Journal of Korean Neurosurgical Society
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• v.59 no.3
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• pp.204-213
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• 2016

Syndromic craniosynostosis has severe cranial stenosis and deformity, combined with hypoplastic maxillary bone and other developmental skeletal lesions. Among these various lesions, upper air way obstruction by hypoplastic maxillary bone could be the first life-threatening condition after birth. Aggressive cranial vault expansion for severely deformed cranial vaults due to multiple synostoses is necessary even in infancy, to normalize the intracranial pressure. Fronto-orbital advancement (FOA) is recommended for patients with hypoplastic anterior part of cranium induced by bicoronal and/or metopic synostoses, and posterior cranial vault expansion is recommended for those with flattening of the posterior part of the cranium by lambdoid synostosis. Although sufficient spontaneous reshaping of the cranium can be expected by expansive cranioplasty, keeping the cranial bone flap expanded sufficiently is often difficult when the initial expansion is performed during infancy. So far distraction osteogenesis (DO) is the only method to make it possible and to provide low rates of re-expansion of the cranial vault. DO is quite beneficial for both FOA and posterior cranial vault expansion, compared with the conventional methods. Associated hydrocephalus and chronic tonsillar herniation due to lambdoid synostosis can be surgically treatable. Abnormal venous drainages from the intracranial space and air way obstruction should be always considered at any surgical procedures. Neurosurgeons have to know well about the managements not only of the deformed cranial vault and the associated brain lesions but also of other multiple skeletal lesions associated with syndromic craniosynostosis, to improve treatment outcome.

• Journal of Dental Rehabilitation and Applied Science
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• v.33 no.2
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• pp.143-153
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• 2017

One of the common complications of dental injury is tooth ankylosis. Unlike adults, when tooth ankylosis occurs in the adolescents, ankylosis interfered the growth of the adjacent alveolar bone, resulting in the developmental failure of the alveolar bone and subsequent open bite. The most common treatment option for ankylosed tooth is extraction. However, when prognosis of ankylosed tooth after extraction is expected to be poor due to severity of infrapositioning or prosthetic replacement cannot be performed immediately, various treatment options should be considered. This report suggests multidisciplinary treatment that might bring functionally and esthetically favorable result included alveolar bone distraction osteogenesis and decoronation of ankylosed maxillary anterior tooth with orthodontic and prosthetic treatments.