Three-dimensional quantitative evaluation of midfacial skeletal changes after trans-sutural distraction osteogenesis for midfacial hypoplasia in growing patients with cleft lip and palate

Tong, Haizhou; Feng, Gao; Yin, Jianhua; Shi, Zehong; Song, Tao; Li, Haidong; Sun, Xinwei; Wang, Yongqian; Yin, Ningbei; Zhao, Zhihui

doi:10.1016/j.jcms.2015.08.027

Cited by 22 publications

(18 citation statements)

References 26 publications

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“…20 reported forward displacement of the zygomatic and infraorbital region in Class III patients and CLP patients, respectively, who underwent bone-anchored maxillary protraction with intermaxillary elastics to miniplates. Recently, our centre had also analysed the 3D midfacial skeletal changes after bone-borne TSDO therapy in growing CLP patients with severe midfacial hypoplasia, and the results revealed rotation advancement of the whole midfacial skeleton with progressively increased forward displacement from the top down along the midface segment and downward displacement in posterior part of the maxillary 17 . To date, these studies only presented the superficial skeletal changes after therapy, but the reason behind such a phenomenon remains unclear.…”

Section: Discussionmentioning

confidence: 99%

“…However, for a certain proportion of those with severe forms, maxillary protraction in either type cannot achieve adequate skeletal changes within less than 6 mm advancement of A-point according to current studies 14–16 . Recently, the technique of trans-sutural distraction osteogenesis (TSDO), which shares the same treatment principle with bone-anchored maxillary protraction using facemask, has just emerged to fill this gap 17,18 . Based on the rigid external distraction system with nickel-titanium shape memory alloy spring and bone-borne traction hooks anchored at the lateral nasal wall, this technique can acquire maximal advancement of the midfacial skeleton associated with maxillary expansion.…”

Section: Introductionmentioning

confidence: 99%

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Imaging study of midface growth with bone-borne trans-sutural distraction osteogenesis therapy in growing cleft lip and palate patients

Tong

Song

Sun

et al. 2019

Sci Rep

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Trans-sutural distraction osteogenesis (TSDO) promotes midface growth in growing cleft lip and palate (CLP) patients with midfacial hypoplasia. The superficial skeletal changes after therapy revealed rotation advancement of the midfacial skeleton associated with differential displacement in each segment, but reports rarely focus on the changes of internal structures, including circummaxillary sutures, the maxillary tuberosity and the maxillary sinus, which may play a crucial role during this process. This study evaluated the computed tomographic (CT) images of 26 growing CLP patients who received bone-borne TSDO therapy. The results revealed that the most prominent new bone formation occurred in the pterygomaxillary suture and pushed the P-point forward. The maxillary first molar exhibited significantly greater advancement compared with the P-point due to the growth of the maxillary tuberosity. The contribution ratio values of the advancement of the maxillary tuberosity and P-point to the maxillary first molar were 26% and 74%, respectively, in UCLP and 25% and 75%, respectively, in BCLP. Furthermore, the maxillary sinus volume was also significantly increased. In conclusion, midface growth with bone-borne TSDO therapy depends on both secondary displacement promoted by sutural bone formation mainly in the pterygomaxillary suture and primary displacement by growth of the maxillary tuberosity and maxillary sinus volume.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Imaging study of midface growth with bone-borne trans-sutural distraction osteogenesis therapy in growing cleft lip and palate patients

Tong

Song

Sun

et al. 2019

Sci Rep

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“…However, for a certain proportion of those with severe forms, maxillary protraction in either type cannot achieve adequate skeletal changes within less than 6 mm advancement of A-point according to current studies (Meazzini et al, 2019). With the development of orthodontic and orthognathic techniques, the technique of trans-sutural distraction osteogenesis (TSDO), which shares the same treatment principle with bone-anchored maxillary protraction using facemask, has just emerged to fill this gap, and has been applied in clinical practice (Tong et al, 2015). TSDO is a biological process that induces the formation of new bone and changes the position of bone by pulling on growing seams under the action of external forces and the forward displacement of the midface can be increased by 2-4 times under traction (Liu et al, 2005).…”

Section: Introductionmentioning

confidence: 96%

Morphological Changes in the Midface of Beagle Dogs Treated by Trans-Sutural Distraction

et al. 2020

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Trans-sutural distraction is a biological process that induces the formation of new bone and changes the position of bone by pulling on growing suture under the action of external forces. Currently, therapy to midfacial hypoplasia treated by trans-sutural distraction has been applied. In this study, Beagle dogs were selected as experimental animals, and a traction device designed by ourselves was applied to Beagle dogs to simulate the treatment process of trans-sutural distraction in human face, so as to provide a basis for the subsequent research on the related mechanism of trans-sutural distraction. The objective is that the animal model can provide the basis for the follow-up study of transsutural distraction. 45 month beagle dogs were randomly divided into two groups 3 in experiment group and 3 in control group. Implant nails were implanted as the bone marker in the bilateral zygomatic temporal suture, zygomandibular maxillary suture and palatine transverse suture in experimental group. The traction of the maxilla was carried out by the external cranial traction frame with canine fossa as bearing point, 800g force each side, elastic traction for 15 days. The control group only implanted the implant nail as the bone marker on both sides of the bone suture. The distance between two implant nails was measured by vernier calipers and X-ray examination, compared with preoperative and postoperative changes. X-ray and cephalometric measurements were used to measure change in the cranial basal angle . HE staining was used to observe the width of the bone seams, the morphology and structure of the cells and the tissue of the new bone under the phase contrast microscope. Then descriptive statistical analysis and t-test between two independent samples are carried out for the measurement data. The experimental group had a good retention of the beagle traction frame. In the experimental group, the maxillaries of dogs were protrudent in the process of traction gradually and the occlusal relationship changed to type II malocclusion. When the traction is 15 days, the coverage distance is about 8~9 mm. Before and after the traction, the distance between landmark points indicated that the spacing between the transverse palatine suture was the largest (experimental group: 5.52±0.19 mm control group 1.31±0.06 mm P<0.05), and zygomaticotemporal suture was the second (experimental group: 3.12±0.15 mm, control group 0.73±0.04 mm, P<0.05), and zygomaticomaxillary suture was less (experimental group: 2.60±0.34 mm, control group 0.53±0.05 mm, P<0.05). The cranial basal angle was no change before and after operation (controlgroup: 32.3±1.3°, experimental group: 33.2±1.1° P>0.05. Histology showed that the collagenous fibers in the suture of the control group were denser and the osteoblasts were visible on the edge of the suture, showing osteogenic activity. The experimental group significantly widened suture (experimental group:1209.388±42.714 µm, control group 248.276±22.864 µm, P<0.05), the number of fibroblasts increased significantl...

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“…Therefore, surgical trauma and risks introduced by osteotomy can be avoided by the application of traction to bones. In addition, it can effectively restore teenagers' or children's mid-face bone functions; this technique provides new techniques and methods for early, minimally invasive correction of midfacial hypoplasia in teenagers [3]. The mechanism of suture osteogenesis through the technique of suturing is complicated.…”

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confidence: 99%

“…We propose a first automatic continuous suture traction osteogenesis in the world to correct skeletal dysplasia in the midface. Since 2005, more than 80 TSDO operations have been successfully performed, and all the patients have achieved satisfactory clinical outcomes [3,8]. We have also established an TSDO rat model to investigate the mechanism of suture traction.…”

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confidence: 99%

Studies on trans-sutural distraction osteogenesis-related genes based on transcriptome sequencing

Wang

Xue

Tong

et al. 2020

Preprint

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Trans-sutural distraction osteogenesis (TSDO) is an important approach to improve mid-face hypoplasia. In recent years, many studies have been carried out on physical mechanisms of TSDO; however, it’s specific cytological and molecular mechanisms are still unclear. In this study, we performed transcriptome sequencing analysis in Sprague Dawley rats at 1 and 2 weeks after suture osteogenesis and compared RNA expression levels between experimental and control groups. At one week, enrichment pathways were mainly up-regulated in muscle- and bone-related pathways. By contrast, pathways of the immune system showed a state of inhibition and down-regulation, especially for B cells; the main immune pathways showed significant down-regulation. However, two weeks later, the experimental group showed positive up-regulation of the pathways related to DNA synthesis and replication, cell cycle, and chromosome replication. At the same time, the immune pathways that were down-regulated in the first week were up-regulated in the second week. In other words, the up-regulated muscle- and bone-related pathways show opposite trends. The expression of bone- and myogenesis-related transcriptome was up-regulated and the immune-related pathways were down-regulated in the experimental group at 1 week. At 2 weeks, the pathways related to bone- and muscle were down-regulated, while those related to cell cycle regulation and DNA replication were up-regulated. These results suggest that musculoskeletal-related molecules may play an important role during suture osteogenesis at 1 week, and immune regulation may be involved in this process; however, at 2 weeks, molecules related to cell proliferation and replication may be a major role.

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Three-dimensional quantitative evaluation of midfacial skeletal changes after trans-sutural distraction osteogenesis for midfacial hypoplasia in growing patients with cleft lip and palate

Cited by 22 publications

References 26 publications

Imaging study of midface growth with bone-borne trans-sutural distraction osteogenesis therapy in growing cleft lip and palate patients

Imaging study of midface growth with bone-borne trans-sutural distraction osteogenesis therapy in growing cleft lip and palate patients

Morphological Changes in the Midface of Beagle Dogs Treated by Trans-Sutural Distraction

Studies on trans-sutural distraction osteogenesis-related genes based on transcriptome sequencing

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