The Versatility of Distraction Osteogenesis in Craniofacial Surgery

Imola, Mario J.; Hamlar, David; Thatcher, Gentry; Chowdhury, Khalid

doi:10.1001/archfaci.4.1.8

Cited by 39 publications

(13 citation statements)

References 55 publications

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“…This choice is based on the results of Richardson et al [44] who observed an exponential increase in stiffness during tibial fracture healing. The period of 75 days was chosen based on an average of times reported for the consolidation and the calcification of the fracture callus [13,27]. The same time scale was set for all tissue types, however in reality one might expect different rates to apply to different tissues.…”

Section: Discussionmentioning

confidence: 99%

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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: Discussionmentioning

confidence: 99%

“…On the other hand, too long a latency period may substantially increase the risk of premature bone union [27], which can hinder the subsequent expansion process.…”

Section: Introductionmentioning

confidence: 99%

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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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“…When compared to conventional mandibular surgery, this method of bone lengthening in the treatment of hypoplastic mandibular ramus due to hemifacial microsomia 23) and bilateral mandibular distraction in the treatment of micrognathia 20) is less invasive and can be performed before the end of the growth period, thus reducing psychological stress 13) . Moreover, smaller screws that can be placed in the oral cavity have recently been made, and such screws are being more widely used 14,22) .…”

Section: Introductionmentioning

confidence: 99%

Stress Distribution in Mandible and Temporomandibular Joint by Mandibular Distraction: A 3-Dimensional Finite-element Analysis

Katada

Arakawa

Ichimura

et al. 2009

Bull. Tokyo Dent. Coll.

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The effects of mandibular distraction on the mandible and its surrounding tissue remain to be clarified. Here, we used a 3-dimensional finite-element method to investigate the effects of unilateral horizontal lengthening of the mandibular body and vertical lengthening of the mandibular ramus on the mandible and temporomandibular joint (TMJ). With horizontal loading that assumed mandibular body lengthening, tensile and compressive stresses were great near the anterior region of the mandibular angle (the loading area). With vertical loading that assumed mandibular ramus lengthening, tensile and compressive stresses were great at the center of the mandibular ramus (the loading area). Under both loading conditions, stress distribution in the TMJ was greater on the loading side than on the non-loading side. With mandibular body lengthening, the center of the mandible deviated in the direction of the non-lengthened side to widen the mandible in the lateral direction. With mandibular ramus lengthening, the occlusal plane tilted in the inferior direction on the lengthened side. In the TMJ, stress was greatest on the affected side during mandibular ramus lengthening, suggesting the need to consider the mandibular condyle on the affected side during this procedure.

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“…Experimental studies in dogs demonstrate regeneration of the mandibular canal containing both neural and vascular elements. However, the functional level of the regenerated neurovascular structures is less than normal (Imola et al, 2002;Imola et al, 2008).…”

Section: Distraction Osteogenesismentioning

confidence: 96%

Distraction Osteogenesis of the Maxillofacial Skeleton: Clinical and Radiological Evaluation

Akay¹

2011

CT Scanning - Techniques and Applications

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The Versatility of Distraction Osteogenesis in Craniofacial Surgery

Cited by 39 publications

References 55 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

Stress Distribution in Mandible and Temporomandibular Joint by Mandibular Distraction: A 3-Dimensional Finite-element Analysis

Distraction Osteogenesis of the Maxillofacial Skeleton: Clinical and Radiological Evaluation

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