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J Craniofac Surg 2022 Jun 28. Epub 2022 Jun 28.

Division of Plastic & Reconstructive Surgery, Children's Hospital of Philadelphia, Philadelphia, PA.

Abstract: Severe congenital mandibular hypoplasia may cause significant upper airway obstruction, often necessitating immediate tracheostomy. Recent surgical advances have demonstrated early intervention with mandibular distraction osteogenesis over tracheostomy may yield desirable aesthetic and functional outcomes. Here we present a case of bilateral mandibular hypoplasia, severe on the right and mild on the left, secondary to Goldenhar syndrome yielding significant tongue-based upper airway obstruction that was surgically corrected with mandibular bone allograft reconstruction of the right condyle, ramus, and posterior half of the mandibular body. Read More

Front Pediatr 2022 23;10:890156. Epub 2022 May 23.

Department of Burns and Plastic Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China.

Objective: The aim of the study was to report our experience with placed allogenic acellular bone matrix and mandibular distraction osteogenesis in Pierre Robin sequence (PRS), and explore the role of distraction in the osteogenesis of acellular bone.

Materials And Methods: A total of 428 neonates with severe PRS managed with placing allogenic acellular bone and bilateral mandibular distraction osteogenesis were included in the study. The procedure included using oblique-shaped osteotomy, fixing bilateral mandibular distractor, instantly extending a 4-6 mm gap, and placing allogenic acellular bone into the gap. Read More

J Craniomaxillofac Surg 2022 Jun 9;50(6):504-514. Epub 2022 May 9.

Oral and Maxillofacial Surgery, Faculty of Dentistry, Ain Shams University, Egypt. Electronic address:

The aim of the current study was to evaluate the effect of the use of computer-guided surgical templates in association with mandibular distraction osteogenesis to correct mandibular asymmetry. In the study group a simulation process was conducted to restore the exact position of the chin skeletally by planning the osteotomy orientation, distractor vector, pin positions, and distraction distance calculation. The Control group was treated with conventional distraction in which an oblique osteotomy was done, and distraction was performed until the midline coincided. Read More

Plast Reconstr Surg 2022 06 12;149(6):1155e-1164e. Epub 2022 Apr 12.

From the Division of Plastic Surgery and the Department of Pediatrics, Emory University; Center for Cleft and Craniofacial Disorders, Children's Healthcare of Atlanta; and Emory University School of Medicine.

Background: The timing of extubation following placement of mandibular distractors in the setting of Pierre Robin sequence is variable across institutional algorithms. Postoperative maintenance of intubation allows for an improvement in airway dimension and tongue positioning before extubation, theoretically decreasing the impact of postoperative airway edema. Maintenance of intubation, however, is not without risk. Read More

J Craniofac Surg 2022 Mar-Apr 01;33(2):485-490

Department of Maxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College. Beijing, China.

Abstract: The treatment for severe hemifacial microsomia (HFM), especially type III case, is extremely difficult. Mandibular distraction osteogenesis (MDO) was rarely used as the primary choice in the treatment of severe type cases. The authors sought to observe the short-term therapeutic outcomes of patients with severe unilateral HFM who underwent MDO first. Read More

J Craniofac Surg 2022 Mar-Apr 01;33(2):e201-e203

Plastic and Reconstructive Surgery Unit, Luis Calvo Mackenna Children's Hospital.

Abstract: The Pierre Robin sequence (PRS) is characterized by the triad of micrognathia, glossoptosis, and airway obstruction. Conservative management in Pierre Robin sequence consists of nasogastric tube feeding and positioning of the neonate (prone or lateral position) that facilitates the anterior position of the tongue or the application of continuous positive nasal pressure. In case of failure of this treatment, emergency tracheostomy and/or mandibular distraction must be performed. Read More

Stomatologiia (Mosk) 2022 ;101(2):25-30

A.I. Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia.

Objective: The aim of the study. Analysis of emerging complications during the method of alveolar distraction osteogenesis in patients with jaw defects. A retrospective analysis of foreign and domestic literature was carried out. Read More

J Clin Sleep Med 2022 Jul;18(7):1749-1755

Department of Pediatrics, Division of Pulmonology, Allergy and Immunology, Weill Cornell Medicine, New York, New York.

Study Objectives: Craniofacial malformations with micrognathia cause high grades of obstructive sleep apnea (OSA) measured by polysomnography (PSG). Mandibular distraction osteogenesis is a novel procedure for upper airway obstruction relief. Our primary objective was to describe the utilization of PSGs to improve obstruction in patients undergoing mandibular distraction. Read More

Plast Reconstr Surg 2022 05 14;149(5):962e-965e. Epub 2022 Mar 14.

From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Yale School of Medicine; and Department of Oral and Maxillofacial Surgery, Yale New Haven Health.

Summary: The optimal management of patients with Robin sequence may include neonatal mandibular distraction osteogenesis, which has been used to achieve excellent functional and aesthetic outcomes in appropriate patients. This article and video vignette depict the treatment of micrognathia and airway obstruction secondary to Robin sequence, demonstrating the planning and surgical approach of the senior author (D.M. Read More

Plast Reconstr Surg 2022 05 14;149(5):1169-1177. Epub 2022 Mar 14.

From the Department of Plastic and Reconstructive Surgery, Wake Forest Baptist Health; Department of Plastic Surgery, Cincinnati Children's Hospital Medical Center; and Hansjörg Wyss Department of Plastic Surgery, New York University Langone Health.

Background: Mandibular distraction osteogenesis is effective for the correction of severe tongue-based airway obstruction in infants with Pierre Robin sequence. Involved osteotomies may damage developing tooth buds and/or the inferior alveolar nerve. The authors evaluated the theoretical safety of various osteotomy techniques to better define infantile mandibular anatomy using computer-aided modeling. Read More

Quintessence Int 2022 May;53(6):534-545

The treatment management of patients with hemifacial microsomia (HM) includes both surgical and nonsurgical approaches and depends primarily on the degree of deformity of the facial and skeletal structures. In this context, the combined efforts of the maxillofacial surgeon, the orthodontist, and the prosthodontist are essential for a satisfactory functional and esthetic outcome. Case presentation: A 31-year-old man presented with a chief complaint of facial asymmetry. Read More

Ann Maxillofac Surg 2021 Jul-Dec;11(2):298-305. Epub 2022 Feb 1.

Department of Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India.

Background: The three commonly employed sequences of distraction osteogenesis (DO) in the management of temporomandibular joint (TMJ) ankylosis with dentofacial deformities include post-arthroplastic distraction osteogenesis (PAD), simultaneous arthroplastic distraction osteogenesis (SAD), and pre-arthroplastic distraction osteogenesis (PrAD).

Objective: The aim of this systematic review is to compare the effectiveness of various sequences of DO in the management of TMJ ankylosis with micrognathia/and obstructive sleep apnea syndrome (OSAS).

Data Sources: A comprehensive online and manual search of English language literature with no date restrictions was done on March 2020. Read More

Atlas Oral Maxillofac Surg Clin North Am 2022 Mar;30(1):57-62

Congenital Craniofacial Care Center, Jacobi Medical Center. Electronic address:

Med Eng Phys 2022 03 9;101:103770. Epub 2022 Feb 9.

Ultra-High Precision Manufacturing Laboratory, Nelson Mandela University, South Africa.

Distraction Osteogenesis (DO) is an emerging technique for reconstruction of bone tissue in different body zones including mandible, tibia, hand, and foot. The application of DO technique in reconstruction of bone tissue has shown promising results compared to conventional reconstruction techniques, including bone grafting, prosthetics, and the vascularized flap. Mechanical distractors, with intermittent manual activation by the user, have been widely used in different reconstruction applications. Read More

Front Surg 2021 9;8:786351. Epub 2022 Feb 9.

State Key Laboratory of Military Stomatology, Department of Oral and Maxillofacial Surgery, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi'an, China.

Objective: The present study aims to increase the concentration of genetically modified bone marrow mesenchymal stem cells (BMSCs) in the distraction osteogenesis (DO) interstitial space and induce the conversion of BMSCs to osteoblasts to improve the osteogenic efficiency in DO and shorten the treatment period.

Methods: Bone morphogenetic protein 1 (BMP-1) and green fluorescent protein (GFP) gene-modified cell sheets of BMSCs were constructed by tissue engineering. Thirty-six New Zealand white rabbits were randomly divided into three groups: group A (the blank control group), group B (the GFP group) with the injection of GFP gene-modified BMSC sheets into the DO gap, and group C (the BMP-1 group) with the injection of BMP-1 gene-modified BMSC sheets into the DO gap. Read More

J Craniofac Surg 2022 05 17;33(3):970. Epub 2022 Feb 17.

J Plast Reconstr Aesthet Surg 2022 Jun 31;75(6):1950-1957. Epub 2022 Jan 31.

Department of Maxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. Electronic address:

Background: Owing to the complex clinical manifestations of hemifacial microsomia (HFM), multidisciplinary cooperation is required to achieve better therapeutic effects in terms of function and aesthetics. This study aimed to explore the efficacy of the expanded two-flap auricular reconstruction combined with mandibular distraction osteogenesis in the treatment of HFM.

Methods: This surgical strategy was performed in three stages. Read More

Tissue Eng Part C Methods 2022 02;28(2):61-72

Division of Bone Diseases, Department of Internal Medicine Specialties, Geneva University Hospital and Faculty of Medicine, Genève, Switzerland.

A variety of surgical techniques and tissue engineering strategies utilizing osteogenic potential of the periosteum have been developed for the repair of extended bone deficiencies. The aim of the present study was to assess the impact of an alternating protocol of periosteal distraction osteogenesis (PDO) on bone regeneration in an intraoral model. Eight adult, male Beagle dogs were used for the study. Read More

Case Rep Dent 2022 13;2022:7651439. Epub 2022 Jan 13.

Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, KSA, Saudi Arabia.

Edentulous patients require an adequate rehabilitation so that the alveolar ridge in the interforaminal region be restored for subsequent implant-supported overdentures. The ultimate goal of distraction is to reconstruct the alveolar ridge to a suitable height and width compatible with Atwood class 2 in an appropriate direction allowing the sagittal interalveolar relation to be normally restored. . Read More

Cleft Palate Craniofac J 2022 Jan 10:10556656211070728. Epub 2022 Jan 10.

Division of Plastic and Reconstructive Surgery, 8404Children's National Hospital, Washington, D.C, USA.

Objective: Robin Sequence (RS), characterized by micrognathia, glossoptosis, and upper airway obstruction, is an increasingly recognized diagnosis. An effective surgical intervention is mandibular distraction osteogenesis (MDO). This study analyzes published evidence regarding facial nerve dysfunction (FND) associated with MDO. Read More

Int J Oral Maxillofac Surg 2022 Jul 21;51(7):892-899. Epub 2021 Dec 21.

Department of Pediatric Intensive Care, Sophia Children's Hospital - Erasmus Medical Center, Rotterdam, The Netherlands.

Patients with mandibular hypoplasia and upper airway obstruction are at an increased risk of feeding and swallowing difficulties. Little has been described regarding these outcomes following mandibular distraction. The aim of this study was to evaluate the effect of mandibular distraction on feeding and swallowing function. Read More

Bioengineering (Basel) 2021 Nov 8;8(11). Epub 2021 Nov 8.

Institute of Orthodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal.

(1) Background: Mandibular deficiency is one of the most common growth disorders of the facial skeleton. Recently, distraction osteogenesis has been suggested as the treatment of choice for overcoming the limitations of conventional orthognathic surgery; (2) Methods: A new custom-manufactured dental-anchored distractor was built and anchored in the first molar and lower canine. It consists of a stainless-steel disjunction screw, adapted and welded to the orthodontic bands through two 1. Read More

Front Pediatr 2021 29;9:771333. Epub 2021 Oct 29.

Oral and Maxillofacial Surgery, Guangzhou Women and Children's Medical Center, Guangzhou, China.

By comparing and studying the changes of food intake, weight, body length, BMI, blood albumin level and other indicators of infants with Pierre-Robin Sequence (PRS) before and after Bilateral Mandible Distraction Osteogenesis operation, to explore the effect of distraction osteogenesis on PRS patients about the improvement of nutrition status. The children with PRS who admitted to the Oral and Maxillofacial Surgery Department of Guangzhou Women and Children's Medical Center from July 2015 to December 2020 were selected. All patients accepted bilateral mandible distraction osteogenesis surgery, and the pre- and post-operative indicators were recorded, such as food intake, weight, length, blood albumin level and others. Read More

J Maxillofac Oral Surg 2021 Dec 7;20(4):674-679. Epub 2020 Oct 7.

Department of Oral & Maxillofacial Surgery, Mallareddy Dental College and Hospital, Hyderabad, India.

Aim: To compare treatment outcome of arthroplasty followed by distraction osteogenesis (AFD) and distraction osteogenesis followed by arthroplasty (DFA) in the management of mandibular deficiencies in temporomandibular joint (TMJ) ankylosis.

Materials And Methods: A total of 20 patients with TMJ Ankylosis were included in the study. Patients were randomly divided into two groups. Read More

J Craniofac Surg 2021 Nov 12. Epub 2021 Nov 12.

Department of Oral and Maxillofacial Surgery, Guangzhou Women and Children's Medical Center Department of Imaging, Guangzhou Women and Children's Medical Center, Guangzhou, China.

Purpose: To study the changes of hyoid position in infants with Robin sequence before and after mandibular distraction osteogenesis, and to explore the related factors.

Material And Methods: Twenty-six infants with Robin sequence underwent bilateral mandibular distraction osteogenesis from May 2016 to April 2020. Three-dimensional computed tomography data of patients before and after surgery were analyzed with Materialise Mimics 17. Read More

Cleft Palate Craniofac J 2021 Nov 3:10556656211054002. Epub 2021 Nov 3.

Hansjörg Wyss Department of Plastic Surgery, 12297New York University Langone Health, 222 East 41st Street, New York, New York, USA.

Purpose: To examine the growth rate discrepancy of the affected and unaffected ramus heights in Pruzansky Type I and Type II mandibles.

Methods: This is a serial retrospective longitudinal growth study of 30 untreated patients (21 males and 9 females) with UCMF (age range from 5 years to 14 years). The mean age of patients was 8. Read More

J Craniofac Surg 2021 Nov-Dec 01;32(8):e773-e778

Department of Orthodontics, School of Dentistry, Seoul National University, Seoul, South Korea.

Abstract: The purpose of this study was to investigate the phenotypes and treatment modalities (Tx-Mod) in patients with Treacher-Collins syndrome (TCS) using a TCS severity index (TSI). The sample consisted of 14 Korean TCS patients treated at the Department of Orthodontics, Seoul National University Dental Hospital during 1998 to 2019. The TSI was calculated by adding the scores from the number of deformity-involved midface structures (eye, ear, zygoma) and the degree of mandibular hypoplasia (Pruzansky-Kaban type, gonial angle, Sella-Nasion-B point angle). Read More

J Craniofac Surg 2022 Mar-Apr 01;33(2):534-538

Division of Plastic and Reconstructive Surgery, Children's Hospital of Philadelphia.

Background: Patients with hemifacial microsomia (HFM) may undergo unilateral mandibular distraction osteogenesis (MDO) before skeletal maturity in an effort to improve facial symmetry. Mandibular distraction osteogenesis's effect on airway volumes have been studied in the past, though to our knowledge, none have accounted for the effect of head and neck posture on airway morphology. This study aimed to tackle this shortcoming, using imaging to analyze the upper airway of patients with HFM before and after surgical intervention with MDO. Read More

J Craniofac Surg 2021 Oct;32(7):2326-2329

Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health.

Introduction: Neonates with severe Pierre Robin sequence (PRS) can be treated by mandibular distraction osteogenesis (MDO), tongue-lip adhesion, or tracheostomy; however, there is an active debate regarding the indications of MDO in this patient population. Published algorithms identify tracheomalacia, bronchomalacia, laryngomalacia, hypotonic syndromes, and central sleep apnea as contraindications for MDO and indications for tracheostomy, but these comorbidities may exist along a spectrum of severity. The authors propose that appropriately selected neonates with PRS who concurrently express 1 or more of these traditional contraindications may be successfully treated with MDO. Read More