The distraction of the maxilla is a standard surgical procedure. So far it is unknown, how the suture will react during the distraction and why not in all cases a sufficient expansion of the maxilla is possible. In an experimental animal study special conserved segments of the maxilla were distracted. In a first group 10 maxilla segments (age of the pig 90 days) and in a second group also 10 maxilla (age 180 days) were fixed in plastic. Using a special screw thread distraction, which was fixed in both parts of the maxilla, a horizontal distraction was possible. In the plastic blocks additionally 6 metal pins were inserted, to determine the horizontal distance. The distraction was simultaneously carried out in 0.25 mm steps to a distance of 2 mm. By four-dimensional (4D) ultrasound (LOGIQ® 9, real time 4D option R7x, GE Ultraschall, Germany) the maxilla could be shown and measured in a water bath after every step. The minimal resolution of this system was 0.3 mm. In a distraction of <0.5 mm sonographically a dispersion of the bone next to the suture could be found. In 90% a linear fracture next to the suture could be found, showing a one-sided as well as a both sided paramedian fracture. But also a fracture which was located in the lateral maxilla was seen. The distance measurement between the pins and in ultrasound showed that after a distraction of 0.25 mm no distraction of the bone and also of the pins could be found. The demonstrated sonographic control of maxilla distraction offers the possibility to visualise micro changes in distraction and shows fracture patterns.
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