Biomechanical and clinical implications of distraction osteogenesis in craniofacial surgery

Meyer, Ulrich; Kleinheinz, Johannes; Joos, Ulrich

doi:10.1016/j.jcms.2003.12.003

Cited by 31 publications

(18 citation statements)

References 68 publications

(55 reference statements)

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“…Following Meyer et al [38], a 2 mm thick callus between the two mandibular ramus was introduced into the model. The callus was meshed using elements 0.25 mm thick, while elements 0.5 mm thick were used to mesh the bone tissue on both the right and the left side of the callus ( Also, preliminary convergence analyses have been performed on the bone callus model, in order to make the model as much as is possible grid independent.…”

Section: Development Of Rate Equation For Materials Propertiesmentioning

confidence: 99%

Tissue differentiation and bone regeneration in an osteotomized mandible: a computational analysis of the latency period

Boccaccio

Prendergast

Pappalettere

et al. 2007

Med Biol Eng Comput

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Mandibular symphyseal distraction osteogenesis is a common clinical procedure to modify the geometrical shape of the mandible for correcting problems of dental overcrowding and arch shrinkage. In spite of consolidated clinical use, questions remain concerning the optimal latency period and the influence of mastication loading on osteogenesis within the callus prior to the first distraction of the mandible. This work utilized a mechano-regulation model to assess bone regeneration within the callus of an osteotomized mandible. A 3D model of the mandible was reconstructed from CT scan data and meshed using poroelastic finite elements. The stimulus regulating tissue differentiation within the callus was hypothesized to be a function of the strain and fluid flow computed by the finite element model. This model was then used to analyse tissue differentiation during a fifteen day latency period, defined as the time between the day of the osteotomy and the day when the first distraction is given to the device. The following predictions are made: (i) the mastication forces generated during the latency period support osteogenesis in certain regions of the callus, and that during the latency period the percentage of progenitor cells differentiating into osteoblasts increases; (ii) reducing the mastication load by 70% during the latency period increases the number of progenitor cells differentiating into osteoblasts; (iii) the stiffness of new tissue increases at a slower rate on the side of bone callus next to the occlusion of the mandibular ramus which could cause asymmetries in the bone tissue formation with respect to the middle sagittal plane. Although the model predicts that the mastication loading generates such asymmetries, their effects on the spatial distribution of callus mechanical properties are insignificant for typical latency periods used clinically. It is also predicted that a latency period of longer than a week will increase the risk of premature bone union across the callus.

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Section: Development Of Rate Equation For Materials Propertiesmentioning

confidence: 99%

Tissue differentiation and bone regeneration in an osteotomized mandible: a computational analysis of the latency period

Boccaccio

Prendergast

Pappalettere

et al. 2007

Med Biol Eng Comput

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“…1b). Following Meyer et al 31 , a 2 mm thick fracture gap between the two mandibular ramus was created (Fig. 1f).…”

Section: Finite Element Modelmentioning

confidence: 99%

The Influence of Expansion Rates on Mandibular Distraction Osteogenesis: A Computational Analysis

Boccaccio

Pappalettere²,

Kelly

2007

Ann Biomed Eng

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“…The distractors were installed following the LeFort-III osteotomy (distractor system: Modus Oss 2.0, Medartis, Basle, Switzerland). Distraction was implemented according to the method of Meyer et al [20], applying a multi-step distraction protocol. Interocclusal splints were used as sliding splints to prevent occlusal impairment.…”

Section: Implementation On the Patientmentioning

confidence: 99%

Potential and Limitations of Cephalometric Analysis of Maxillofacial Bone Movement in the Case of LeFort III-Distraction

et al. 2005

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Biomechanical and clinical implications of distraction osteogenesis in craniofacial surgery

Cited by 31 publications

References 68 publications

Tissue differentiation and bone regeneration in an osteotomized mandible: a computational analysis of the latency period

Tissue differentiation and bone regeneration in an osteotomized mandible: a computational analysis of the latency period

The Influence of Expansion Rates on Mandibular Distraction Osteogenesis: A Computational Analysis

Potential and Limitations of Cephalometric Analysis of Maxillofacial Bone Movement in the Case of LeFort III-Distraction

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