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Mandibular Distraction Osteogenesis (mandibular + distraction_osteogenesi)
Selected AbstractsOsteoblastic activity of the rabbit temporomandibular joint during distraction osteogenesis assessed by [18F]fluoride positron emission tomographyEUROPEAN JOURNAL OF ORAL SCIENCES, Issue 2 2002Arja Muhonen The purpose of the study was to evaluate the effects of irradiation and hyperbaric oxygenation (HBO) on osteoblastic activity of the temporomandibular joint (TMJ) region during mandibular distraction osteogenesis. Unilateral distraction was performed on 19 rabbits, which were divided into five groups. One group served as a control group, while the others received either high- or low-dose irradiation in the TMJ region before surgery. Some of the animals were also given HBO 18 times at 2.5 ATAŚ90 min preoperatively. Osteogenesis was assessed by [18F]fluoride positron emission tomography at the end of the distraction. Osteoblastic activity was higher on the distracted side in all groups, except in the high-dose irradiated group without preceding HBO. HBO increased osteogenesis on both sides after radiotherapy. It is concluded that increased osteoblastic activity reflects increased pressure on the TMJ region of the distracted side, resulting from lengthening. It seems that more remodeling is required after irradiation than without preceding radiotherapy. After radiotherapy, HBO increased osteoblastic activity. [source] Effect of mandibular distraction osteogenesis on developing molarsORTHODONTICS & CRANIOFACIAL RESEARCH, Issue 4 2007M Kleine-Hakala Structured Abstract Authors,,, Kleine-Hakala M, Hukki J, Hurmerinta K Objective,,, To observe the effect of mandibular distraction osteogenesis (DO) on developing molars. Design,,, Descriptive clinical study. Setting,,, University hospital setting. Seventeen children (mean age 7.6 years) with various syndromes (hemifacial/craniofacial microsomia, Goldenhar syndrome, Treacher Collins syndrome, Nager syndrome and Pyle,Bakwin,Krida syndrome) participated. Experimental variable,,, Severely retrognathic lower jaws were distracted (mean 30 days) with an extraoral bicortically fixed DO device. Outcome measure,,, Consecutive panoramic tomograms were analysed after a mean follow-up period of 3.6 years, range 1,6.9 years. Results,,, The mandibular molars were affected by DO in 13 of the 17 patients which included 18 of 63 mandibular molars studied. Structural changes included root malformations, hindered tooth development and the destruction of tooth follicles. Positional changes such as shifted and tilted teeth were also found. Three injured teeth failed to erupt. These changes were because of splitting of the tooth follicle during the osteotomy (22%), piercing of the tooth follicle by the pin (39%) or migration of tooth germ towards the newly created bone (39%). Fifteen per cent of first molars, 43% of second molars and 31% of third molars were affected during the distraction process. Of all dental injuries, 44% were noticed while the appliance was in place. A further 17% of injuries were noted between 3 months and 1 year postoperatively and 33% during the second postoperative year. Conclusions,,, Although dental injuries are a minor disadvantage compared with the vast benefits offered by DO, focusing on these drawbacks might lead to re-consideration of the type of the device as well as the timing of DO. [source] Resolving Feeding Difficulties With Early Airway Intervention in Pierre Robin SequenceTHE LARYNGOSCOPE, Issue 1 2008Michael E. Lidsky MD Abstract Objectives/Hypothesis: To observe rates of gastrostomy tube (g-tube) placement in Pierre Robin Sequence (PRS) and to determine whether relieving airway obstruction solves feeding difficulties. Study Design: All PRS referrals to a multidisciplinary cleft team for children at a tertiary pediatric hospital from January 1988 to June 2006 were retrospectively reviewed. Methods: Patients were analyzed for occurrence of g-tube placement, neurologic disorders, and airway intervention including tracheotomy and mandibular distraction osteogenesis. Results: Sixty-seven PRS patients were divided into two categories: 51 (76.1%) isolated PRS (iPRS) and 16 (23.9%) with additional disorders and syndromes (sPRS). Patients were then placed into two subgroups: those who received early airway intervention and those who received late or no airway intervention. Of the 51 iPRS children, 12 (23.5%) received early airway intervention, none of whom required a g-tube. There were 39 (76.5%) children who received late or no airway intervention, and 5 (12.8%) of these required g-tube placement. Of the 16 sPRS children, 8 (50%) received early airway intervention, and 7 (87.5%) of these still required a g-tube. Of the remaining 8 (50%) sPRS patients who received late or no airway intervention, 5 (62.5%) required a g-tube. Conclusion: In children with iPRS, feeding difficulties can be resolved with early airway intervention. Delaying airway intervention may necessitate feeding assistance because all of the iPRS children who required a g-tube fell into this category. The presence of additional disorders and syndromes further complicates treatment because most of the sPRS children required g-tubes regardless of airway intervention. [source] | ||||||||||