Advantages Of Distraction Osteogenesis Research Articles

Accelerated cranial distraction protocol for one-piece fronto-orbital distraction osteogenesis without bandeau in patients with craniosynostosis

This study aimed to compare the bony relapse ratios of standard and accelerated distraction protocols (ADP) in one-piece fronto-orbital distraction osteogenesis (DO).Patients with unilateral or bilateral coronal synostoses who underwent one-piece fronto-orbital DO were included. The accelerated cranial distraction protocol included a 3-day latency period and a distraction rate of 1–2 mm/day, followed by a 4-week consolidation period. Intracranial volume was measured using computed tomography (CT) before the surgery, at the end of the consolidation period, and 1 year after the removal of distractors. The intracranial volume changes and relapse ratios were calculated.This study included 32 patients; of these, 16 were included in each of the ADP and standard protocol (SP) groups. The mean ages were 1.4 years and 1.6 years in the ADP and SP groups, respectively (p = 0.895). In the ADP and SP groups, the expanded volumes were 270.9 ± 90.3 cm3 and 284.6 ± 149.7 cm3 (p = 0.91) and the growth-corrected expanded volumes were 162.1 ± 67.5 cm3 and 177.1 ± 105.2 cm3, respectively (p = 0.867). The relapse and growth-corrected relapse ratios showed no significant differences between the two groups, suggesting similar stability between the two protocols. The relapse ratios were 7.1 ± 4.8% and 7.3 ± 5.0% (p = 0.91) and the growth-corrected relapse ratios were −3.0 ± 3.3% and −2.4 ± 2.7%, respectively (p = 0.498).Within the limitations of the study, it seems that the ADP can shorten the distraction period without compromising stability. This may contribute to resolving the disadvantages and highlighting the advantages of DO.

Prosthetic rehabilitation of a traumatic mandibular defect using alveolar distraction and an implant-supported hybrid prosthesis: A clinical report

Prosthetic rehabilitation of edentulous sites with concomitant alveolar deficiency is always an esthetic and functional challenge. In the current case, the advantages of distraction osteogenesis and hybrid prosthesis with a cast metal framework were used to restore esthetics and function. The surgical elegance of distraction osteogenesis combined with the variety of features of hybrid prosthesis ensured successful rehabilitation, patient comfort and ease of maintenance. This case report highlights the need for meticulous preoperative planning and selection of the right options, both surgical and prosthetic to effectively restore complex oral defects using implants. Traumatic defects are mostly accompanied by hard and soft tissue loss. This report describes the surgical and prosthetic treatment of a patient with a traumatic mandibular defect. The trauma resulted in the loss of numerous mandibular teeth and extensive loss of bone particularly in the anterior mandible. In order to restore the lost hard and soft tissues, the treatment plan comprised of alveolar distraction osteogenesis in the anterior mandible followed by an implant supported screw-retained FP-3 prosthesis. This article also describes a technique to ensure a passive well-fitting cast metal framework for the fixed removable screw-retained hybrid prosthesis. Clinical Relevance to Interdisciplinary Dentistry Placement of implants in compromised edentulous ridges often results in a compromised final prosthetic outcome. This case report describes an interdisciplinary approach to manage hard and soft tissue ridge defects using alveolar distraction osteogenesis, followed by implant placement and prosthetic rehabilitation using a hybrid denture. The integration of the faculties of prosthodontics, oral and maxillofacial surgery, and oral and maxillofacial radiology was the key factor that determined the successful completion of this complex and technically demanding case.

Three-year follow-up of a patient with hemifacial microsomia treated with distraction osteogenesis, temporary anchorage devices, and orthodontics

The purpose of this case report is to describe the treatment, including 3-year follow-up records, for a patient with hemifacial microsmia. Treatment included the unusual use of temporary anchorage devices to correct the cant of the occlusal plane. The advantages of distraction osteogenesis are discussed. The successful outcome depended on the collaboration of the orthodontist and the craniofacial surgeon.

《歯科補綴における再生医療の方向性》骨再生の臨床―口腔外科的立場から―

Bone augmentation or the alveolar ridge augmentation procedure is inevitable for functional and esthetic prosthetic oral rehabilitation. In this article, conventional alveolar ridge augmentation methods are clinically demonstrated and are reviewed with reference to literature. In addition, distraction osteogenesis (DO), which has drawn considerable attention as a regenerative medicine, was clinically demonstrated. Then, the conventional augmentation methods and distraction are compared. Indications, advantages, and disadvantages of conventional augmentation methods including bone grafts, guided bone regeneration (GBR) and GBR with titanium micromesh (TIME technique) are demonstrated. Next, the mechanisms, indications, and advantages of DO are demonstrated and compared with conventional methods. Although conventional augmentation methods are well established, there are some problems including donor site morbidity and risks of wound dehiscence and infection. DO seems to have advantages compared to conventional augmentation methods. However, there still have some clinical problems such as difficulty in vector control and technique sensitivity. For less morbidity and better efficacy in alveolar ridge bone augmentation, tissue engineering offers potential in the future. However, further basic and clinical study will be necessary for clinical application.

Comparison of Treating Tibial Nonunion with Bone and Soft Tissue Defect: Ilizarov Only Versus Free Flap and Ilizarov

Purpose : To statistically analyze the advantages of distraction osteogenesis in combination with free flap in the treatment of tibial open fracture with bone and soft tissue defect. Materials and Methods : Twenty patients with tibial open fracture with bone and soft tissue defect were treated by distraction osteogenesis with or without flap. Patients were followed up for a minimum of 12 months and retrospectively analyzed, for the admission period, the out patient follow-up period, and the intravenous antibiotic period, and distraction consolidation indices were determined. Results : Those treated with free flap showed statistically significance shorter antibiotic period, admission period, and distraction consolidation indices. Conclusion : Free flap and distraction osteogenesis with an Ilizarov external fixator has many advantages for treating tibial open fracture with bone and soft tissue defect.