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.
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ABSTRACT: To determine the results of Bilateral Distraction Osteogenesis (DO) versus traditional methods in treatment of micrognathia.Journal of Acute Disease. 12/2014; 67.
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ABSTRACT: Robin sequence is a condition that includes the triad of micrognathia, glossoptosis and upper airway obstruction, although many authors now consider that cleft palate is also an important part of the sequence. It can be classified as isolated, syndromic or associated with other anomalies without an identifiable syndrome. A possible genetic cause for isolated Robin sequence is yet under preliminary investigation, and the finding of siblings with the same condition, as are the two children we present in this work, is extremely rare, with only 9 similar cases previously described. Our article includes the description of the treatment plan and outcome for both children. We review the current concepts and trends of epidemiology, genetics, diagnosis and different treatment options available. We conclude that in cases of failure of more conservative measures in the first weeks, mandibular distraction osteogenesis may be a good and rational option for the management of isolated Robin sequence, as is currently supported in recent literature, providing a reliable way of avoiding tracheostomy.Journal of Plastic Reconstructive & Aesthetic Surgery 08/2014; · 1.47 Impact Factor
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ABSTRACT: This article reviews the most current practice guidelines in the diagnosis and management of patients born with cleft lip and/or palate. Such patients frequently have multiple medical and social issues that benefit greatly from a team approach. Common challenges include feeding difficulty, nutritional deficiency, speech disorders, hearing problems, ear disease, dental anomalies, and both social and developmental delays, among others. Interdisciplinary evaluation and collaboration throughout a patient's development are essential.Otolaryngologic Clinics of North America 10/2014; 47(5):821–852. · 1.34 Impact Factor