Meta-Analysis of Mandibular Distraction Osteogenesis: Clinical Applications and Functional Outcomes
ABSTRACT Mandibular distraction osteogenesis has been used effectively to treat syndromic craniofacial deformities. In recent years, its scope of application has widened to include treatment of airway obstruction in adults and children and nonsyndromic class II mandibular hypoplasia. So far, there has been no evidence-based review of mandibular distraction osteogenesis for mandibular lengthening.
Two rounds of searches were performed by two independent assessors. The first-round PubMed search used the keywords "mandible" and "distraction osteogenesis." In the second-round search, the reference lists of the articles were retrieved. For both rounds, abstracts and then full articles were reviewed and selected on the basis of a set of inclusion and exclusion criteria.
The 178 retrieved articles yielded 1185 mandibular distraction osteogenesis patients: 539 received unilateral mandibular distraction osteogenesis and 646 received bilateral mandibular distraction osteogenesis. Mandibular distraction osteogenesis was reported to improve facial asymmetry and retrognathia (50.1 percent), correct the slanted lip commissure (24.7 percent), and improve or level the mandibular occlusal plane (11.1 percent) in unilateral asymmetry cases, whereas bilateral mandibular distraction osteogenesis was shown to be effective in preventing tracheostomies for 91.3 percent of neonates or infants with respiratory distress, and in relieving symptoms of obstructive sleep apnea for 97.0 percent of children and 100 percent of adult patients.
Mandibular distraction osteogenesis is effective in treating craniofacial deformities, but further clinical trials are required to assess the long-term stability and to compare the treatment with conventional treatment methods, especially in cases of obstructive sleep apnea or class II mandibular hypoplasia.
- SourceAvailable from: Hamid Karimi
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- "The degree of involvement of each section varies; unilateral and bilateral. When the deformity is bilateral, generalized micrognathia is observed   . "
ABSTRACT: To determine the results of Bilateral Distraction Osteogenesis (DO) versus traditional methods in treatment of micrognathia.12/2014; 67(4). DOI:10.1016/S2221-6189(14)60064-0
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ABSTRACT: PURPOSE FOR REVIEW: Childhood sleep-disordered breathing (SDB) is associated with a myriad of health problems that underscore the need for early diagnosis and treatment. Children with SDB present with behavior problems, deficits of general intelligence, learning and memory deficits, evidence of brain neuronal injury, increased cardiovascular risk, and poor quality of life. Children are in a rapid state of cognitive development; therefore, alterations of health and brain function associated with SDB could permanently alter a child's social and economic potential, especially if the disorder is not recognized early in life or is treated inadequately. RECENT FINDINGS: There is evidence that the majority of the problems associated with SDB improve with treatment. Treatment strategies are now being aimed at mechanisms underlying the disorder. There are multiple treatment options available to children; some are novel, with pending treatments on the horizon that may replace age-old therapies such as adenotonsillectomy or nasal positive pressure. SUMMARY: It is imperative that healthcare workers actively seek out signs and symptoms of SDB in patients to improve early detection and treatment for prevention of long-term morbidity.Current opinion in pulmonary medicine 12/2008; 14(6):551-8. DOI:10.1097/MCP.0b013e3283130f80 · 2.96 Impact Factor
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ABSTRACT: To provide a concise review of recent advances in mandibular distraction osteogenesis as it applies to the field of pediatric otolaryngology. The successful use of mandibular distraction osteogenesis is becoming well established in the literature. Large case series with long-term follow-up are lending strong evidence in support of mandibular distraction osteogenesis in the management of airway obstruction and craniofacial deformities resulting from mandibular deficiency. These recent publications offer refinements in patient selection as well as expanding indications for this surgical intervention. At the same time, an emphasis on reduction of complications and better patient compliance has led to a search for improved device technology. Additionally, there has been an increased interest in understanding of the basic science of distraction osteogenesis at a molecular level. Numerous researchers are investigating the cellular mechanisms involved in distraction osteogenesis bone healing and are attempting to manipulate these factors to improve patient outcomes. The field of pediatric distraction osteogenesis continues to advance with active research and study. As clinical experience increases, new models of device design and molecular manipulation have emerged on the scene, promising improved patient outcomes and fewer complications.Current opinion in otolaryngology & head and neck surgery 01/2009; 16(6):548-54. DOI:10.1097/MOO.0b013e3283177f81 · 1.39 Impact Factor