Mandibular distractions in jaws deformations - as a sufficient method or in combination with orthognatic surgery

Abstract


Aim: improvement of mandibular distraction osteogenesis and rehabilitation algorithm of patients with combined jaws deformities caused by mandible hypoplasia. Matherial and methods: we report treatment results of 6 patients with the combined jaws deformities and mandible hypoplasia (developmental and congenital). All of the patients have undergone Steiner cephalometric analysis on the presurgical stage, after mandible distraction osteogenesis (DO) and after orthognathic surgery. The assessment of callus formation was done by ultrasound. All patients have undergone orthodontic treatment during retention period after distraction. The need of orthognathic surgery was defined at the end of retention period. Final evaluation was provided accordingly to functional and esthetic results. Results. Distration speed adjustments were the case in 5 patients to get normotrophic type of bone regeneration. Mean allongation was 17±5 mm. All of the patients had fully matured bony regenerate after mandibular distraction. That gave the opportunity to provide bimaxillary ortognathic surgery and genioplasty simultaneously with distractors removement in 3 patients. In 2 patients was performed only genioplasty with distractors removement. In 1 case with preoperative distraction computer planning there was no need of any additional surgical procedures. Acceptable functional and esthetic results were achieved after DO and orthodontic treatment. Conclusion. The combination of surgical methods (DO and ortognathic surgery) and early orthodontic treatment allow complete recovery. Use of sophisticated algorithm of DO, including computer planning, conservative surgical methods and curvilinear distractors as well as the ultrasonic assessment of distraction, allow to get fully matured bone regenerate and predictable treatment results in all cases. Sometimes the DO alone permits to avoid additional surgical procedures.


Full Text

Restricted Access

About the authors

Alexandr L. Ivanov

Central Research Institute of Stomatology and maxillofacial surgery of the Ministry of Healthcare and Social Development

Author for correspondence.
Email: dr.ivanov.pa@gmail.com
119121, Moscow, Russian Federation

G. Yu Chikurov

Central Research Institute of Stomatology and maxillofacial surgery of the Ministry of Healthcare and Social Development

Email: info@eco-vector.com
119121, Moscow, Russian Federation

N. V Starikova

Central Research Institute of Stomatology and maxillofacial surgery of the Ministry of Healthcare and Social Development

Email: info@eco-vector.com
119121, Moscow, Russian Federation

A. G Nadtochiy

Central Research Institute of Stomatology and maxillofacial surgery of the Ministry of Healthcare and Social Development

Email: info@eco-vector.com
119121, Moscow, Russian Federation

P. I Agapov

Central Research Institute of Stomatology and maxillofacial surgery of the Ministry of Healthcare and Social Development

Email: info@eco-vector.com
119121, Moscow, Russian Federation

References

  1. McCarthy J.G., Stelnicki E.J., Grayson B.H. Distraction osteogenesis of the mandible: a ten-year experience. Semin Orthod. 1999; 5 (1): 3-8.
  2. Надточий А.Г., Шамсудинов А.Г., Букатина Н.В., Боярина Н.И. Эхографический контроль формирования дистракционных регенератов. Ультразвуковая диагностика. 2000; (4): 58.
  3. Yin L., Tang X., Shi L., Yin H., Zhang Z. Mandibular distraction combined with orthognathic techniques for the correction of severe adult mandibular hypoplasia. J. Craniofac. Surg. 2014; 25 (6): 1947-52. doi: 0.1097/SCS.0000000000000973.
  4. Weber E., Meyer C., Ernoult C., Chatelain B., Benassarou M. 3D mandibular distraction planification in a case of severe temporomandibular ankylosis. Rev. Stomatol. Chir. Maxillofac. Chir. Orale. 2015; 116 (3): 153-60. doi: 10.1016/j.revsto.2015.03.002.
  5. Kaban L.B., Seldin E.B., Kikinis R., Yeshwant K., Padwa B.L., Troulis M.J. Clinical application of curvilinear distraction osteogenesis for correction of mandibular deformities. J. Oral Maxillofac. Surg. 2009; 67 (5): 996-1008. doi: 10.1016/j.joms.2009.01.010.
  6. Steiner C. Cephalometrics in clinical practice. Angle Orthod. 1959; 29: 8-29.

Statistics

Views

Abstract - 37

PDF (Russian) - 0

Cited-By


Article Metrics

Metrics Loading ...

Refbacks

  • There are currently no refbacks.


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies