Distraction osteogenesis in the craniofacial complex. I. Mandible, hemifacial microsomia.
Title:
Distraction osteogenesis in the craniofacial complex. I. Mandible, hemifacial microsomia.
Author:
P. A. Kyzas M. Andriotellis L.-V. Vassiliou I. Fakitsas M. J. Papagrigorakis
Appeared in:
Hellenic orthodontic review
Paging:
Volume 7 (2004) nr. 2 pages 129-151
Year:
2004
Contents:
The term distraction osteogenesis describes the technique of new bone production between surgically created osseous segments that are gradually separated, as well as the simultaneous muscular and soft tissue changes occurring as an adjustment to the new morphology of the area under distraction. The aim of this study is to investigate the literature concerning indications and contraindications of distraction osteogenesis, surgical techniques and distraction appliances used. Furthermore, clinical pictures of the application of distraction osteogenesis are presented. The main indications for implementation of distraction osteogenesis in the craniofacial complex are severe deficiencies of the maxilla and mandible, bi- or unilateral, syndrome-related or not. Distraction osteogenesis is absolutely contraindicated, as a method of new bone production, in the treatment of patients with craniofacial dysplasias due to excessive osseous activity. Continuous collaboration between the orthodontist and the maxillofacial surgeon is of outmost importance throughout the process. Part I of this review refers to the basic principles of this technique and the factors concerning the application of distraction osteogenesis for the treatment of mandibular growth anomalies. Mandibular anomalies at the three planes (horizontal, sagittal and vertical) are separately examined and the indications, surgical techniques, distraction appliances, advantages and disadvantages of the method in each case are reported. The issue is also approached from an orthodontic perspective. In conclusion, distraction osteogenesis is a new, developing and much promising technique which, nevertheless, is no panacea; it should therefore be applied only in such cases where it is absolutely indicated.