Purpose: Manipulations of the newly created regenerate, using adjustable multiplanar devices during distraction osteogenesis or as a 1-step molding procedure at the end of the distraction process, may be necessary to correct the position of the mandible. Treatment of complex deformities may require preplanned major angulation provided by adjustable devices. We sought to assess the effects of molding the fresh regenerate on vascularization and early bone formation within clinically relevant dimensions.
Materials And Methods: Evaluation of the nature of the problem in mechanical terms was based on a geometrical model, its dimensions chosen with clinical relevance. Custom-made devices, allowing the simultaneous compression and stretching of a regenerate 10 mm long, were fixed bilaterally in the angular region of beagle mandibles (n = 14). Angulation of 20 degrees (n = 7) or 30 degrees (n = 7) was performed immediately after ending the lengthening period, and the animals were killed after a 7-day consolidation period. The vascular system was stained via intravital Procion red infusion and post mortem carbon ink (Deperussol P130; Degussa AG, Frankfurt, Germany) perfusion to assess possible damages. Qualitative and quantitative evaluations of the mineralized tissue were performed with contact radiography, quantified computed tomography, and histologic assessment.
Results: The only finding indicating mechanical forces acting on the regenerate was related to orientation of the collagenous fibers. Vascular damage was not observed. Mineralization patterns were identical in both the compressed and the stretched zone. The degree of angulation had no visible impact on early bone formation, even if compression and stretching of the regenerate at a range of 33% to 54% exceeds most clinical requirements. However, the amount of callus formation differed independent of the shaping angle, revealing parameters other than the degree of angulation to be important.
Conclusions: Although the newly forming bone is highly sensitive to nonphysiologic strain during the lengthening process, a completed fresh regenerate, created by distraction osteogenesis, can be manipulated to a considerable extent without endangering early callus formation. Manipulation of the regenerates would provide a precise final result, minimizing the need for secondary corrections and diminishing treatment duration and costs.
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http://dx.doi.org/10.1016/j.joms.2004.07.008 | DOI Listing |
J Craniofac Surg
January 2025
Division of Plastic and Reconstructive Surgery, Children's National Hospital.
Facial nerve dysfunction (FND) is a well-recognized but poorly documented complication of mandibular distraction osteogenesis (MDO) for Robin sequence (RS). This study aims to document the authors' experiences with FND and identify risk factors associated with this adverse event. A retrospective review of a prospectively gathered database was performed to identify patients with RS who underwent MDO at the authors' institution from March 2016 to June 2023.
View Article and Find Full Text PDFJ Craniofac Surg
January 2025
Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, School of Medicine, Shanghai Jiao Tong University.
Background: This paper presents the authors' team's research on a craniofacial surgical robot developed in China. Initiated in 2011 with government funding, the craniofacial surgical robot project was officially launched in Shanghai, developed jointly by the Ninth People's Hospital affiliated with Shanghai Jiao Tong University School of Medicine and the Shanghai Jiao Tong University medical-engineering team. Currently, based on multiple rounds of model surgeries, animal experiments, and clinical trials, our team is applying for approval as a Class III medical device from the National Medical Products Administration (NMPA).
View Article and Find Full Text PDFJ Craniofac Surg
January 2025
Department of Craniomaxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
Objective: Finite element analysis (FEA) of the biomechanical properties of the modified extraoral distractor device used in the mandibular distraction of craniofacial microsomia patients.
Materials And Methods: Finite element analysis (FEA) models of 5 patients under 2 working conditions, the instance when the distractor is activated and when the distractor participates in mastication, were included in the current study. To conduct the FEA, load boundary conditions (35.
J Craniofac Surg
December 2024
Member of Sociedad Argentina de Ortodoncia, Member of International Society of Craneofacial Surgery, Member of Asociación Latinoamericana de Ortodoncia, Buenos Aires, Argentina.
Craniofacial syndromes present with exorbitism and airway obstruction as a result of upper and middle facial hypoplasia. Classical subcranial Lefort III (LF III) or monobloc distraction osteogenesis (DO) using an external craniofacial device is used to treat these deformities. These procedures are done during mixed dentition, in most cases, advancing an abnormal face, to a more normal position.
View Article and Find Full Text PDFCleft Palate Craniofac J
January 2025
Department of Physiology and Medical Biochemistry, Faculty of Medicine, Airlangga University, Surabaya, Indonesia.
Objective: This study compares mandibular distraction osteogenesis (MDO) and tracheostomy in managing severe airway obstruction in patients with the Pierre Robin sequence (PRS).
Design: A systematic review and meta-analysis following PRISMA guidelines was performed. Literature searches were conducted across PubMed, ScienceDirect, Cochrane Library, Scopus, E.
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