Treatment of Postoperative Midfacial Deformity of Chilopalatognathus by Distraction Osteogenesis With a Self-Constructed Tooth-Borne Distraction Device
2
Citation
0
Reference
10
Related Paper
Citation Trend
Abstract:
Distraction osteogenesis has recently evolved a challenging technique to overcome major drawbacks of the traditional orthodontic treatment modalities. The aim of this study was to evaluate the therapeutic efficacy of patients with chilopalatognathus who have premaxillary deficiency through distraction osteogenesis using a self-constructed tooth-borne distraction device.Individual tooth-borne distraction devices were used for advancement of the maxillary anterior segment. Distraction was performed for 26 patients in accordance with the specific requirements of each individual. Cephalometric radiographs were taken before treatment (T1), after distraction (T2), and after consolidation for 8 weeks (T3).Cephalometric analysis revealed that the premaxilla was moved forward and that the length of palatal plane increased. In 2 cases, the distractor did not work during distraction and was removed.Distraction osteogenesis using individual tooth-borne distraction devices in patients with chilopalatognathus could effectively resolve soft tissue insufficiencies and hypoplasia of the maxilla.Keywords:
Maxillary hypoplasia
Premaxilla
To simulate maxillary distraction osteogenesis and evaluate the change of soft and hard tissue before and after treatment, using Computer-Assisted Simulation System for Orthognathic Surgery( CASSOS 2001).A fourteen-year-old boy with severe maxillary hypoplasia, due to unilateral cleft lip and palate, was analysed by cephalometric analysis. The simulations of maxillary distraction osteogenesis (Le Fort I osteotomy and Le Fort II osteotomy) were re-analysed. After the treatment, cephalometric analysis was preformed again. The data were compared.The maxillary hypoplasia was well treated using maxillary distraction osteogenesis; Compared with Le fort I osteotomy, more satisfactory results can be obtained by Le fort I distraction osteogenesis.Maxillary distraction osteogenesis is a better way to treat severe maxillary hypoplasia with operated CLP than maxillary osteotomy. CASSOS 2001 can help surgeons and patients on simulation and evaluation of maxillary distraction osteogenesis, and on decision of treatment plan.
Maxillary hypoplasia
Cephalometric analysis
Cite
Citations (0)
Distraction osteogenesis (DO) is a mechanobiological process of producing new bone and overlying soft tissues through the gradual and controlled distraction of surgically separated bone segments. The process of bone regeneration during DO is largely affected by distraction parameters. In the present study, a distraction strategy with varying distraction rates (i.e., “rate-varying distraction”) is proposed, with the aim of shortening the distraction time and improving the efficiency of DO. We hypothesized that faster and better healing can be achieved with rate-varying distractions, as compared with constant-rate distractions. A computational model incorporating the viscoelastic behaviors of the callus tissues and the mechano-regulatory tissue differentiation laws was developed and validated to predict the bone regeneration process during DO. The effect of rate-varying distraction on the healing outcomes (bony bridging time and bone formation) was examined. Compared to the constant low-rate distraction, a low-to-high rate-varying distraction provided a favorable mechanical environment for angiogenesis and bone tissue differentiation, throughout the distraction and consolidation phase, leading to an improved healing outcome with a shortened healing time. These results suggest that a rate-varying clinical strategy could reduce the overall treatment time of DO and decrease the risk of complications related to the external fixator.
Bone Formation
Cite
Citations (9)
Navigation System
Mandible (arthropod mouthpart)
Cite
Citations (5)
Mandible (arthropod mouthpart)
Cite
Citations (23)
Distraction osteogenesis is a method of enhancing bony deficiencies of the hypoplastic cleft maxilla. Whether it is the result of inherited growth deficiency or of iatrogenic causes from operative intervention, 20 to 25% of cleft maxilla patients require maxillary advancement. Traditionally, this has been done by standard orthognathic surgery at varying LeFort levels. Predictable results have been achieved with standard techniques in minor to moderate maxillary hypoplasia; however, limited advancement and relapse is common in severe cases. Distraction osteogenesis has improved results in these patients by allowing soft tissue relaxation and gradual bone generation. Therefore, greater movement of the craniofacial skeleton is possible in severe cases of maxillary retrusion with lower relapse rates.
Maxillary hypoplasia
Cephalometry
Cite
Citations (18)
Premaxilla
Cite
Citations (10)
Objective To simulate maxillary distraction osteogenesis and evaluate the change of soft and hard tissue before and after treatment,using Computer-Assisted Simulation System for Orthognathic Surgery(CASSOS2001).Methods A fourteen-year-old boy with severe maxillary hypoplasia,due to unilateral cleft lip and palate,was analysed by cephalometric analysis.The simulations of maxillary distraction osteogenesis(Le Fort I osteotomy and Le Fort II osteotomy)were re-analysed.After the treatment,cephalometric analysis was preformed again.The data were compared.Results The maxillary hypoplasia was well treated using maxillary distraction osteogenesis;Compared with Le fort I osteotomy,more satisfactory results can be obtained by Le fort I distraction osteogenesis.Conclusion Maxillary distraction osteogenesis is a better way to treat severe maxillary hypoplasia with operated CLP than maxillary osteotomy.CASSOS2001can help surgeons and patients on simulation and evalution of maxillary distraction osteogenesis,and on decision of treatment plan.
Maxillary hypoplasia
Cephalometric analysis
Cite
Citations (0)
Cite
Citations (9)
Craniofacial surgery
Cite
Citations (44)
Cephalometry
Maxillary hypoplasia
Anterior maxilla
Cite
Citations (0)