• 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.

• 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.

• 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.

• Korean Journal of Veterinary Research
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• v.60 no.3
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• pp.145-153
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• 2020

This study aimed to evaluate the effects of a bioabsorbable bone hemostatic agent comprising poly (ethylene glycol-propylene glycol) copolymers (PEG-PPG) on hemostasis and osteogenesis. Bilateral 3 mm diameter calvarial defects were created in 99 male Sprague-Dawley rats. The defects were filled with PEG-PPG or bone wax. The defects of control group were left unfilled. Virtual autopsy was performed to evaluate bioabsorption. The calvaria were subjected to x-ray microtomography (microCT) and histological examination. Bone volume fraction (BV/TV) and bone mineral density (BMD) were measured using microCT; furthermore, white blood cell count and histological examination were performed. After application of PEG-PPG and bone wax, immediate hemostasis was achieved. Autopsy revealed that PEG-PPG disappeared within 48 h at the application site; in contrast, bone wax remained until 12 weeks. The PEG-PPG and control groups showed significantly more osteogenesis than the bone wax group with respect to BV/TV and BMD at 3, 6, and 12 weeks (p < 0.05). Histology revealed that the bone wax group exhibited little bone formation with inflammation. In contrast, PEG-PPG and control groups showed significantly more qualitative osteogenesis than the bone wax group (p < 0.01). In conclusion, PEG-PPG showed immediate hemostasis and was absorbed to allow progressive osteogenesis.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.28 no.6
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• pp.549-558
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• 2006

During distraction osteogenesis, the angiogenic activity is crucial factor in the new bone formation. The aim of this study was to detect the autocrine growth activity in the cellular components of the distracted periosteum with observation of the expression of vascular endothelial growth factor (VEGF) and its receptors following the mandibular distraction osteogenesis. Unilateral mandibular distraction (0.5 mm twice per day for 10 days) was performed in six mongrel dogs. Two animals were sacrificed at 7, 14, and 28 days after completion of distraction, respectively. The distracted lingual periosteum was harvested and processed for immunohistochemical examinations. After then, we observed the expression of VEGF, Flt-1 (VEGFR-1), and Flk-1 (VEGFR-2) in the osteoblasts and immature mesenchymal cells of the distracted periosteum. At 7 days after distraction, the expression of VEGF and its receptors were significantly increased in the cellular components of the distracted periosteum. Up to 14 days following distraction, the increased expressions were maintained in the osteoblastic cells. At 28 days after distraction, the expression of VEGF and its receptors decreased, but VEGF was still expressed weak or moderate in the osteoblastic cells of distracted periosteum. The expression pattern of VEGF and its receptors shown here suggested that VEGF play an important role in the osteogenesis, and these osteoblastic cell-derived VEGF might act as autocrine growth factor during distraction osteogenesis. In the other word, the cellular components in the distracted periosteum, such as osteoblasts and immature mesenchymal cells, might have autocrine growth activity during distraction osteogenesis.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.6
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• pp.620-627
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• 2000

The purpose of this study is to investigate the clinical and histologic changes in distraction osteogenesis according to different distraction rates in the rat's tibia. Eighteen adult rats underwent open osteotomy and attachment of an external unilateral distraction device in the middle of left tibia. Latency was allowed for 7 days before distracton began. The distraction device was activated with varying distraction rates of 0.5mm, 1mm, 2mm and same rhythm of twice a day until 5mm length gain was achieved. The animals were sacrificed at post-distraction 4, 8 weeks to observe the bony healing states. At each group, clinical, radiographic and histologic studies were done. The results obtained from this study were as follows: 1. The 0.5mm group showed excellent osteogenesis than other groups. The new bone was formed by intramembranous bone formation mostly and endochondral bone formation partly. 2. The 1mm group showed delayed osteogenesis and incomplete bony healing at 8 weeks. 3. The 2mm group showed weak osteogenesis and fibrous union or nonunion at 8 weeks. From these results, it could be stated that distraction rate of 0.5mm per day was most useful in rat's tibia. The rate of 1mm showed delayed bony healing and needed more consolidation period. Distraction osteogenesis is a excellent clinical method for regenerating local bone deficiencies in limbs and craniofacial area. The more studies needed for the higher animals and human about distraction rates and other biomechanical factors on the basis of this study.

• 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.

• 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.

• 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.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.29 no.6
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• pp.444-449
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• 2003

Distraction osteogenesis is a biologic process in which new bone is formed between bone fragments being separated by a tractional force. This technique has the advantage of initiating new bone growth without bone transplantation and promoting the growth of soft tissue. Mandibular distraction osteogenesis has shown to be effective to treat congenital or acquired mandibular hypoplasias. On the basis of positive results with implant-supported prostheses, the use of implants in the distracted site can significantly help stabilize the prosthesis. We obtained good result in the patient with mandibular deficiency due to trauma, who have been reconstructed with distraction osteogenesis and implant. We report our experiences with literature view.