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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- "Strength of the bone after distraction osteogenesis, however, was approximately forty percent less than normal bone when studied in the mandible (Schwarz et al., 2010). This technique, first developed in long bones, has been effectively used to lengthen the mandible in cases of mandibular hypoplasia (Ow and Cheung, 2008), or expand the cranial vault in cases of complex craniosynostosis (Figure 3; Taylor et al., 2012). While distraction osteogenesis was initially developed for linear vectors of growth, strategies are being developed to apply distraction to the complex shapes of the facial skeleton, via use of multi-directional distraction devices (Schendel, 2011). "
ABSTRACT: Craniofacial disorders present markedly complicated problems in reconstruction because of the complex interactions of the multiple, simultaneously affected tissues. Regenerative medicine holds promise for new strategies to improve treatment of these disorders. This review addresses current areas of unmet need in craniofacial reconstruction and emphasizes how craniofacial tissues differ from their analogs elsewhere in the body. We present a problem-based approach to illustrate current treatment strategies for various craniofacial disorders, to highlight areas of need, and to suggest regenerative strategies for craniofacial bone, fat, muscle, nerve, and skin. For some tissues, current approaches offer excellent reconstructive solutions using autologous tissue or prosthetic materials. Thus, new "regenerative" approaches would need to offer major advantages in order to be adopted. In other tissues, the unmet need is great, and we suggest the greatest regenerative need is for muscle, skin, and nerve. The advent of composite facial tissue transplantation and the development of regenerative medicine are each likely to add important new paradigms to our treatment of craniofacial disorders.Frontiers in Physiology 12/2012; 3:453. DOI:10.3389/fphys.2012.00453 · 3.53 Impact Factor
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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 · 2.76 Impact Factor