Article

Analysis of skeletal movements in mandibular distraction osteogenesis

Harvard University, Cambridge, Massachusetts, United States
Journal of Oral and Maxillofacial Surgery (Impact Factor: 1.43). 04/2005; 63(3):335-40. DOI: 10.1016/j.joms.2004.06.057
Source: PubMed

ABSTRACT

The purpose of this study was to use geometric parameters of movement, calculated from 3-dimensional computed tomography (CT) data, to determine the curvilinear distractor dimensions required to correct mandibular deformities in a series of patients.
Preoperative CT scans from 15 patients with symmetric (n = 5) and asymmetric (n = 10) deformities were imported into a CT-based software program (Osteoplan; an open-source visualization application developed by Gering et al at the Surgical Planning Laboratory [SPL, Brigham and Womens Hospital, Boston, MA]). The software was used to reconstruct virtual 3-dimensional models from these scans. Two experienced surgeons, working with a computer scientist, then used Osteoplan to create an ideal treatment plan for each patient. In each case, the 3-dimensional curvilinear movement was quantified using 4 "parameters of movement" (POMs). These parameters were then used to prescribe a distraction device capable of executing the planned skeletal correction. Curvilinear distractor dimensions calculated by Osteoplan included the radius of curvature of the prescribed device, and the distractor elongation, pitch, and handedness.
Treatment plans including POMs were developed for each patient. The radii of curvature for the prescribed distractors ranged from 2.3 to 14.1 cm, the distractor elongation dimensions ranged from 0.7 to 3.2 cm, and the pitch (horizontal plane) dimensions ranged from 0.005 to 0.8 cm. Handedness was either a left (n = 12) or right (n = 8) turning helix.
The results of this study indicate that, using geometric parameters of movement calculated from 3-dimensional CT scans, curvilinear devices could be prescribed for correction of the range of skeletal deformities in this group of patients.

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    • "Yeshwant et al.[269]proposed quantifying the 3D curvilinear movement to elongate the mandible by 4 parameters of movement: radius of curvature, elongation, pitch, and handedness (left-or right-turning helix). Based on these parameters, a distraction device was constructed to execute a computer-assisted plan for skeletal correction[269]. 3D CAS simulation and model surgery provide accurate orientation of the distraction vectors[131]. "
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