• 대한치과교정학회지
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• 제50권2호
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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.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제30권4호
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• pp.261-270
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• 2004

The purpose of this experiment was to examine the histological changes and the pattern of expression of type I, II collagen in the elongated area by distraction osteogenesis in the rabbit mandible. Sixteen rabbits weighing 2.5kg-3kg were used for this experiment. Experimental group was distracted at the rate of 0.7mm, twice/day for 7days, and control group was only osteotomized. After 5 days latency, osteotomic site is distracted for 7days. Consolidation period is 28days. The animal was sacrificed at the 3rd, 7th, 14th, 28th day after the operation. The distracted bone was examined by histological analysis and RT-PCR analysis. The results were summarized as follows: 1. Experimental group was observed that the gaps between the distracted bone edges were occupied by new bone. 2. Expression of Type I collagen were detected throughout the experiment in both groups and Expression of Type I collagen were markedly increased during distraction and consolidation period in experimental group than control group. 3. Expression of Type II collagen were detected throughout the experiment in both groups and expression of Type II collagen were maintained at high level during distraction and consolidation period in experimental group than control group. From these results, in contrast to type II collagen, type I collagen seemed to be more expressed by mechanical stimuli during distraction and consolidation period. The predominent mechanism of new bone formation in the distraction gap was intramembranous bone formation, but some of the regenerated bone was formed by endochondral ossification.

• 대한치과보철학회:학술대회논문집
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• 대한치과보철학회 1999년도 Asian Academy of Prosthodntics. Korean Academy of Prosthodontics
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• pp.96.2-97
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• 1999

• 대한치과의사협회지
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• 제43권2호통권429호
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• pp.76-85
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• 2005

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제30권6호
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• pp.516-525
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• 2004

Mandibular symphyseal distraction osteogenesis is an alternative approach for correcting mandibular transverse deficiencies and dental crowding. The traditional approaches for these are extraction of teeth and arch expansion with traditional orthodontic treatment. Also extractions are usually unavoidable in patients with severe crowding. The purpose of this study is to evaluate the effect of mandibular symphyseal distraction osteogenesis by use of tooth-borne expansion appliance. All of 12 patients had been performed distraction osteogenesis. The surgical procedures were accomplished under local anesthesia and intravenous sedation in an ambulatory surgical setting using a routine distraction protocol. The latency period was 5 days or 7 days after symphyseal osteotomies. The rate & rhyth is a intermittent, 0.75mm or 1.0 mm per day and stabilized for 6, 8 weeks after distraction. The time of orthodontic tooth movement after distraction was variable from 2 weeks to 8 weeks (mean 3 weeks). All patients had been evaluated with study casts, plain periapical films, panorama radiograms before & after surgery. Mandibular symphyseal distraction osteogenesis increased mandibular arch width and corrected dental crowding, with paralleling tooth-borne movement, without proclination of the mandibular incisors.

• 한국융합학회논문지
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• 제7권6호
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• pp.75-80
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• 2016

악골기형에 따른 외과적 치료방법은 상악골 또는 하악골을 직접 늘리거나 줄이는 방식을 이용한다. 골신장술(distraction osteogenesis)은 열성장한 악골에 치밀뼈절단술(corticotomy)을 시행한 후, 골신장기(jaw bone distractor)를 사용하여 간헐적인 힘을 골에 부과하며 골의 길이를 늘여주는 대표적인 방법이다. 그러나 이러한 골신장기는 피부를 관통한 채 골에 고정되기 때문에, 비심미적이며 감염이나 흉터 등의 많은 문제점이 발생한다. 이 연구에서는 구내형 골신장기(intraoral jaw bone distractor) 개발을 위해 유한요소분석을 시행하여 핵심구동부의 안정성을 시뮬레이션한 후, 골신장기를 제작하였다. 융합연구를 통하여 향후 무선형 골신장기를 제작하기 위한 기반 자료를 구축하였으며, 관련 자료는 골신장술의 근본적인 문제점을 해결할 수 있는 가능성을 제시하며, 제반 기술은 다양한 의료기기 개발 기술에 활용될 수 있다

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제33권4호
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• pp.312-321
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• 2007

Purpose: Distraction osteogenesis has been applied to the maxillofacial implantology and good experimental and clinical results have been reported. However, histologic studies of implants placement on distraction osteogenesis of atrophic alveolar ridges are scarce. In this study, we compare the bone formation between in the transport part and in the distraction part by histomorphometric analysis. Materials & methods: Three adult beagle dogs were served as experimental subjects. The 2 premolars and 1st molar were extracted on the Lt. side of mandible in each beagle dog. After one month later, osteotomy was performed and distraction device was adapted. Distraction was performed with gradual incremental separation of two bone pieces at a rate of 1.0mm per day for 5 days. During consolidation phase, new bone was formed in the distraction zone between the separated bone pieces. 5 weeks after distraction phase, 3 implants were placed in each beagle dog. The implants were inserted through transport part and distraction part and inferior basal bone. The animals were sacrificed at 2 weeks, 4 weeks, and 12 weeks after implant placement. BIC and BA of implants on distraction part and transport part were measured histomorphometrically. Results: BIC, BA increased after implant placement as time goes by passes and new bone formation was slightly higher in transport part than in distraction part at 2 weeks, 4 weeks after implant placement. At 12 weeks after implant placement, BIC, BA of were 74%, 61% in transport part and 77%, 59% in distraction part, therefore there were no difference in BIC and BA between transport part and distraction part at 12 weeks after implant placement.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제32권5호
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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.

• 대한치과교정학회지
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• 제31권5호
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• pp.499-504
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• 2001

하악골 횡적 성장결핍에 의한 하악 전치부의 총생을 치료하는데 성인의 경우 발치가 종종 요구된다. 그러나 발치에 의한 안모 변화가 바람직하지 않을 때 견인골 신장술을 시행하여 하악 정중부의 확장은 횡적 공간을 확보하여 빠른 교정치료 및 안정성을 확보할 수 있는 방법으로 고려된다. 하악 정중부 견인골 신장술을 시행한 후 tooth-borne type 과 tooth & bone-borne type distractor를 사용하여 latency, distraction, consolidation period를 거쳐 하악 정중부 횡적 확장을 시행하여 전치부 총생을 빠르게 치료할 수 있었으며, 두가지 방법에 의한 치유과정을 비교한 결과 치주적인 요소와 골 형성과정은 유사하였으며, 악관절 부위의 퇴행적 증상변화는 관찰되지 않았다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제29권5호
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• pp.429-438
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• 2007

Transport distraction osteogenesis has been introduced recently to correct skeletal malformations and discrepancies in the maxillofacial area. To reconstruct 3-dimensitonal mandibular shape, this transport distraction can be considered with the use of reconstruction plate. A 23-years-old male having unilateral mandibular body and angle defects, who had been operated of partial mandibular resection due to unicystic ameloblastoma, was treated by transport distraction procedures with ThreadLock transport $distractor^{(R)}$ (KLS Martin Co., Germany) through the rail of reconstruction plate (Osteomed Co., USA). After being distracted 35 mm defect from mandibular angle to body, and consolidated for 16 weeks, allogenic bone graft on docking site was performed with removal of transgingival pin. For more than 13 weeks follow up period after consolidation period, gradual increase of radiopacity in the radiographic examination was shown, and the curved mandibular continuity according to the reconstruction plate was made firmly. These transport distraction osteogenesis in the mandible was able to be considered as the good and minimally invasive technique for the reconstruction of mandibular discontinuity. Young patient was also very satisfactory for these results.