Significance of distraction osteogenesis of the craniomaxillofacial skeleton – A clinical review after 10 years of experience with the technique

Adolphs, Nicolai; Ernst, Nicole; Menneking, Horst; Hoffmeister, Bodo

doi:10.1016/j.jcms.2014.01.018

Cited by 22 publications

(9 citation statements)

References 32 publications

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“…It allows for the individualized correction of a present transverse maxillary deficiency and may be indicated already before skeletal maturity, especially in syndromal or dysostotic conditions [ 37 ]. In spite of the fact that, according to Nada’s web-based survey distraction osteogenesis cannot yet be regarded as evidence-based care [ 38 ], the principle of gradual expansion of bone and surrounding soft tissues as realized by distraction osteogenesis seems to provide reliable results in patients affected by dentofacial and craniofacial anomalies [ 39 , 40 ]. Skeletal anchorage also offers new perspectives for the early correction of dentofacial anomalies.…”

Section: Discussionmentioning

confidence: 99%

Contemporary Correction of Dentofacial Anomalies: A Clinical Assessment

et al. 2016

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Contemporary computer-assisted technologies can support the surgical team in the treatment of patients affected by dentofacial deformities. Based on own experiences of 350 patients that received orthognathic surgery by the same team from 2007 to 2015, this clinical review is intended to give an overview of the results and risks related to the surgical correction of dentofacial anomalies. Different clinical and technological innovations that can contribute to improve the planning and transfer of corrective dentofacial surgery are discussed as well. However, despite the presence of modern technologies, a patient-specific approach and solid craftsmanship remain the key factors in this elective surgery.

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Section: Discussionmentioning

confidence: 99%

Contemporary Correction of Dentofacial Anomalies: A Clinical Assessment

et al. 2016

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“…If severe growth restriction of the craniomaxillofacial skeleton is present or has to be expected distraction techniques have proven their feasibility. [ 8 ] TPD nowadays is considered to be the “state of the art procedure” for surgical assisted maxillary expansion. [ 9 ] However, there is little literature about TPD during the mixed dentition before skeletal maturity.…”

Section: Discussionmentioning

confidence: 99%

Transpalatal distraction for the management of maxillary constriction in pediatric patients

Adolphs

Ernst

Hoffmeister

et al. 2015

Ann Maxillofac Surg

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Context:The management of severe maxillary constriction can be challenging. For that purpose surgically assisted maxillary expansion by transpalatal distraction (TPD) can typically be recommended after skeletal maturity. However in selected cases bone borne transpalatal distraction devices can contribute to improve maxillary constriction considerably earlier already during mixed dentition.Aims:To assess the possibility of bone borne transpalatal distraction in pediatric patients.Settings and Design:Clinical paper.Materials and Methods:Since 2010 TPD has been applied to six pediatric patients during mixed dentition when severe maxillary constriction was present and conventional orthodontic widening has already failed. Individually selected devices (Surgitec, Belgium) were inserted in general anaesthesia and distraction was performed according to well known parameters.Results:Maxillary constriction could be improved in all six patients without any drawbacks by bone borne devices during mixed dentition. Skeletal conditions were obviously improved for subsequent orthodontic or orthognathic therapy without functional impairment. Follow-up is up to 36 months after device removal.Conclusions:Transpalatal Distraction is recommendable in selected pediatric patients if massive growth disturbance is present or has to be expected. TPD allows for individually adapted maxillary expansion by selection and positioning of appropriate devices in combination with intraoperative testing of maxillary movements and controlled bone removal.

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“…Maxillary surgical advancement is the most common surgical technique for correcting maxillary hypoplasia in patients with cleft lip and palate. An advancement of more than 10 mm in patients with no cleft and 6 mm in patients with cleft lip and palate is beyond the limit of conventional LeFort I advancement, and in such cases DO for advancement of the maxilla can be used [28][29][30][31][32].…”

Section: Distraction Osteogenesis In Sagittal Maxillary Advancementmentioning

confidence: 99%

“…Consolidation period of 8 to 12 weeks is generally accepted in UCLP patients to prevent the risk of possible skeletal relapse [32,51,54,62]. During consolidation period, bone mineralization of the distraction zone and bone remodelling occur according to the Ilizarov's principles.…”

Section: Technique and Protocolmentioning

confidence: 99%

Distraction Osteogenesis in the Treatment of Maxillary Hypoplasia

Olmez-Gurlen¹

2016

Advanced Techniques in Bone Regeneration

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The aim of this chapter is to review literature reporting on the use of internal distraction osteogenesis and rigid external distraction osteogenesis and to determine the biomechanical effects of internal distractors in the treatment of maxillary hypoplasia, especially in patients with cleft lip and palate (CLP), and compare the results with non-cleft patient. The standard osteotomy used for distraction osteogenesis of the hypoplastic maxilla is LeFort I. An advancement of more than 10 mm in patients with no cleft and 6 mm in patients with CLP is beyond the limit of LeFort I osteotomy, and in such cases distraction osteogenesis for advancement of the maxilla can be used. Distraction osteogenesis (DO) is a biological process involving the formation of new bone between viable bone segments that are gradually separated by incremental traction. The external and internal usage of distraction osteogenesis in the treatment of maxillary hypoplasia in patients with cleft lip and palate is a reliable, reproducible and stable alternative method to conventional one-step LeFort I advancement techniques. Biomechanical evaluation of internal maxillary distraction osteogenesis produces mathematical results to help the surgeon and the orthodontist to understand better the therapeutic effects on the maxillofacial bones and sutures of the craniofacial system.

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Significance of distraction osteogenesis of the craniomaxillofacial skeleton – A clinical review after 10 years of experience with the technique

Cited by 22 publications

References 32 publications

Contemporary Correction of Dentofacial Anomalies: A Clinical Assessment

Contemporary Correction of Dentofacial Anomalies: A Clinical Assessment

Transpalatal distraction for the management of maxillary constriction in pediatric patients

Distraction Osteogenesis in the Treatment of Maxillary Hypoplasia

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