Positional changes and stability of bone segments during simultaneousbilateral mandibular lengthening and widening by distraction

Gonzalez, M.; Bell, W. H.; Guerrero, C.; Buschang, Peter H.; Samchukov, Mikhail

doi:10.1054/bjom.2001.0642

Cited by 14 publications

(7 citation statements)

References 22 publications

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“…Elongation of the mandible by distraction, on the other hand, is a less complicated surgical procedure that may preserve the integrity of the inferior alveolar nerve and vascular supply. 19 In this study, we found lengthening of approximately 20% of the ramus size (measured by panorex and the cephalogram) up to 6 months following the distraction (Tables 3 and 4). 5 From the very first stages of bone distraction of the human mandible, it was recognized that the development of a simple, multidirectional, miniaturized and stable device would be necessary for wide use of the principles of bone distraction in the craniofacial skeleton.…”

Section: Discussionsupporting

confidence: 54%

Mandible Distraction Using Internal Device

Freitas

Alonso²,

Busato³

et al. 2007

Journal of Craniofacial Surgery

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For many years, surgeons have sought a method to treat severe facial deformities without using bone grafts and extensive surgery. Distraction osteogenesis offers this promise. The technique used in mandibular hypoplasia follows the basic principles proposed by Ilizarov which states that the device must be elongated 1 mm per day to create optimal bone production. Despite the widespread implementation of this recommendation to include the 1-mm/day separation, doubt still exists as to whether this is the optimal treatment regimen. Intraoral devices with percutaneous activator pins were used in 16 patients with hypoplastic mandibles. The results of distraction were documented by panorex and cephalogram of the mandible. The length of the ramus as well as multiple mandible dimensions and facial angles were measured. The panorex and cephalogram of the mandible were effective in demonstrating the significant increase in length of the mandible and ramus, as well as the entire mandible, but there was no correlation between the stretching obtained by the distraction device and that measured by the radiographic studies. The S-N-B angle was the only facial angle in which there is a statistically significant increase measured and this appeared to be related to a mandible rotation. It is concluded that the mandible distraction (using an intraoral device and an external activator pin) was effective in increasing the ramus length and both the panorex and the cephalogram were effective in demonstrating this morphologic change. There was no correlation between the clinical result and the radiographic studies demonstrating that the clinical judgment still has a significant role in controlling mandible distraction.

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Section: Discussionsupporting

confidence: 54%

Mandible Distraction Using Internal Device

Freitas

Alonso²,

Busato³

et al. 2007

Journal of Craniofacial Surgery

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“…14 To predict the effects of DO, the distraction vector as well as various factors such as muscle force and the orientation or type of distractor should be considered because 3D movements and flexure of the mandible itself may occur during mastication. Gonzalez et al 22 mentioned the biomechanical effects of the medial pterygoid muscle in their animal study of simultaneous bilateral mandibular lengthening and midsymphyseal widening. However, there were a few FEA studies dealing with midsymphyseal DO that concerned the effect of the masticatory muscles in humans.…”

Section: Discussionmentioning

confidence: 99%

“…However, the rotational effect of bony segments that arose by the mechanical expansion could also be compensated by masticatory muscle force. 22 Thus, it could also be estimated in a clinical situation that in the patient with strong masseter muscle or horizontal growth pattern, such compensation mechanism might be more remarkable. To which degree our findings were influenced by the masticatory forces can only be speculated.…”

Section: Discussionmentioning

confidence: 99%

“…25 In several studies, however, the displacement pattern of the teeth and the bony structures during the consolidation period of DO has been reported to be substantially different from the time immediately after the completion of midsymphyseal expansion. 10,22,27 This implies that after the displacement of bony segments, due to additional biomechanical actions, gradual adaptation to this change occurred in the dental arch. Hence, to simulate the difference of the mandibular changes immediately after expansion and after a certain period of bone consolidation, a complex factor such as occlusal force, the vector, and the force of the adjacent soft tissues including muscles from a new mandibular position must be considered.…”

Section: Discussionmentioning

confidence: 99%

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A finite element study on the effects of midsymphyseal distraction osteogenesis on the mandible and articular disc

Kim

Cha

Choi

et al. 2012

The Angle Orthodontist

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Objective: To evaluate the biomechanical effect of midsymphyseal distraction osteogenesis with three types of distractors on the mandible and articular disc using a three-dimensional finite element model analysis. Materials and Methods: A virtual model of the mandible was produced from computed tomography scan images of a healthy 27-year-old man. On the finite element model of the mandible, expansion of the bone-borne, tooth-borne, and hybrid type distractors were simulated with the jawclosing muscles. The displacement and stress distribution of the mandible and articular disc were analyzed. Results: With the bone-borne appliance the alveolar process area was displaced more than the basal bone area. The tooth-borne appliance displaced the mandibular body in a parallel manner and showed high level of the von Mises stress in the alveolar process and the ramal region as well as in the condylar neck area. The hybrid type showed medium amount of displacement and stress distribution compared with the bone-borne and tooth-borne type. At the articular disc the compressive stress was concentrated in the anteromedial and posterolateral area, and it was highest in the tooth-borne distractor, followed by hybrid appliance and bone-borne appliance. Conclusions: The tooth-borne distractor produced more parallel bony widening in the midsymphyseal area and larger expansion in the molar region; however, it induced higher stress concentration on the articular disc than the hybrid appliance and bone-borne appliance. Whether any long-term side effects on the temporomandibular joint are anticipated, especially in tooth-borne distractor, remains to be investigated. (Angle Orthod. 2012;82:464-471.)

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“…Ortodontistler; Schwarz apareyi, lingual ark ve fonksiyonel apareyler yardımıyla alt çeneyi transversal ve sagittal yönde genişletmeye çalışmışlardır (6,7). Ancak ortodontik tedaviyle alt çenede köpek dişleri arası mesafenin arttırıldığı olguların uzun dönemli takiplerinde yüksek oranda relaps ile karşılaşılmıştır (8,9).…”

Section: Introductionunclassified

Alt Çene Orta Hat Distraksiyonu: Olgu Sunumu

Sahin¹,

Türk²

2018

J Int Dent Sci

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ÖZAlt çenenin orta hat distraksiyonu, dar apikal kaideye sahip alt çenenin transversal yöndeki yetersizliği ile birlikte ön dişlerde çapraşıklığın mevcut olduğu olgularda uygulanabilecek bir yaklaşımdır. Diş çekimi, stripping, tipping veya alt çene ark genişletmesi tedavi seçeneği olarak düşünülebilirken, bu tedavilerin uzun dönem sonuçlarının öngörülemeyeceği ve nüks ile karşılaşılabileceği bildirilmiştir. Bu olgu sunumunda; üst ve alt ön dişlerinde çapraşıklık şikâyeti olan ve V şekline sahip alt arka sahip 14 yaşındaki kadın hastanın hızlı üst çene genişletmesi ve alt çene orta hat distraksiyonu sonrası sabit mekaniklerle tedavisi sunulmaktadır.Tedavinin tamamlanmasının ardından memnun edici bir estetik görünüş ve fonksiyonel anlamda sağlıklı bir kapanış elde edildi.Anahtar sözcükler: Alt çene, Distraksiyon, Ortodonti. ABSTRACTMandibular midline distraction is a treatment alternative of cases which have anterior crowding with mandibular transversal deficiencies While traditional approaches such as extractions, stripping, dental tipping or mandibular arch expansion can resolve the deficiency, treatment of transverse discrepancies with mandibular expansion or incisor protrusion has been shown to be unpredictable and could result in relapse and undesirable side-effects in the long term. This case report describes treatment with fixed mechanics after mandibular midline distraction and RME in A 14-year-old female patient with V-shaped mandibular arch and upper and lower anterior crowding.After the treatment, satisfying esthetic appearance and functionally sound occlusion was obtained.

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Positional changes and stability of bone segments during simultaneousbilateral mandibular lengthening and widening by distraction

Cited by 14 publications

References 22 publications

Mandible Distraction Using Internal Device

Mandible Distraction Using Internal Device

A finite element study on the effects of midsymphyseal distraction osteogenesis on the mandible and articular disc

Alt Çene Orta Hat Distraksiyonu: Olgu Sunumu

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