914 results match your criteria Distraction Osteogenesis of the Maxilla


Lefort II distraction with zygomatic repositioning versus Lefort III distraction: A comparison of surgical outcomes and complications.

J Craniomaxillofac Surg 2021 Apr 28. Epub 2021 Apr 28.

Craniofacial Center, Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA, 98105, USA. Electronic address:

The aim of the study was to determine if the additional surgical complexity of Lefort II distraction with zygomatic repositioning (LF2ZR) results in increased complications compared to Lefort III distraction (LF3). A retrospective review was performed of all LF3 and LF2ZR advancements performed by the senior author over 15 years. Demographic, operative, postoperative, and cephalometric data were collected from initial procedure through greater than 1 year postoperatively. Read More

View Article and Full-Text PDF

Distraction Osteogenesis: Mandible and Maxilla.

Facial Plast Surg 2021 May 3. Epub 2021 May 3.

Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas.

Mandibular and maxillary deformities commonly require surgical intervention. Prior to distraction osteogenesis, traditional modalities involving single-staged translocation and rigid fixation were used to correct these craniofacial anomalies. Distraction osteogenesis has evolved as a compelling alternative for treating aesthetic and functional dentofacial defects. Read More

View Article and Full-Text PDF

Virtual planning and CAD/CAM-assisted distraction for maxillary hypoplasia in cleft lip and palate patients: Accuracy evaluation and clinical outcome.

J Craniomaxillofac Surg 2021 Apr 21. Epub 2021 Apr 21.

Division of Maxillofacial Surgery, Città della Salute e della Scienza Hospital, University of Torino, Italy.

The aim of this prospective study was to report the experience with a specific guided distraction protocol for the treatment of CLP patients with severe midface hypoplasia. From January 2016 to April 2019, six consecutive, non-growing, CLP patients with maxillary hypoplasia underwent a specific distraction protocol based on the use of VSP, CAD/CAM-generated surgical splints, cutting guides, prebent internal maxillary distractors, early removal of distractors, and acute callus manipulation and fixation. STL files for VSP, using multislice CT scans taken preoperatively (T0) and 3 months after distractor removal (T1) were superimposed using the free software 3D Slicer and Geomagic Wrap to evaluate the accuracy of maxillary repositioning and assess 3D bone changes. Read More

View Article and Full-Text PDF

One-Year Treatment Outcome of Profile Changes After Transcutaneous Maxillary Distraction Osteogenesis in Growing Children With Cleft Lip and Palate.

Cleft Palate Craniofac J 2021 Apr 5:10556656211005638. Epub 2021 Apr 5.

Department of Craniofacial Orthodontics, Department of Dentistry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung.

Objective: To evaluate the long-term stability of LeFort I osteotomy followed by distraction osteogenesis with a transcutaneous rigid external device for the treatment of severe maxillary hypoplasia in patients with cleft lip and palate.

Patients And Methods: Nine patients with cleft lip and palate underwent rigid external distraction after a LeFort I osteotomy for maxillary advancement. Lateral cephalometric films were analyzed for assessment of treatment outcome and stability in 1 month, 6 months, and 1 year after distraction. Read More

View Article and Full-Text PDF

Revascularized Fibula Free Flap Reconstruction and Curvilinear Transport Distraction Osteogenesis in Closure of Large Postmaxillectomy Defects: A New Gold Standard?

Ann Maxillofac Surg 2020 Jul-Dec;10(2):304-311. Epub 2020 Jul 2.

Department of Mechanical Engineering, University of Cape Town, Rondebosch, Cape Town, South Africa.

Introduction: The revascularized fibula free flap (RFFF) is the most popular method of postmaxillectomy reconstruction. This article proves that the use of curvilinear transport distraction osteogenesis (CTDO) is an efficacious way in closing large defects in the maxilla and a superior alternative to the RFFF.

Methods And Materials: In a prospective cohort study of six postmaxillectomy patients, CTDO was applied and the new bone (regenerate) was compared with the parent bone from which it had been regenerated. Read More

View Article and Full-Text PDF

Surgical Planning for Cleft Lip and/or Palate-Induced Moderate-to-Severe Midfacial Hypoplasia.

J Craniofac Surg 2021 Mar-Apr 01;32(2):492-495

Cleft Lip and Palate Department.

Background: Distraction osteogenesis and conventional bimaxillary orthognathic surgery have been performed for the treatment of midfacial hypoplasia for a long time. However, the effect of these 2 techniques on the maxilla, mandible, and whole-facial profile is significantly different. In this study, we aimed to measure the pre- to post-treatment changes in maxillary prominence, mandible size, and facial length and compare them between these 2 techniques to inform selection of the best technique. Read More

View Article and Full-Text PDF

Temporomandibular joint dislocation in patients with cleft lip and palate after maxillary distraction osteogenesis: Three case reports.

Medicine (Baltimore) 2021 Feb;100(6):e24012

Center for Cleft Lip and Palate Treatment.

Introduction: Distraction osteogenesis (DO) is a widely used for cleft and palate related maxillary hypoplasia. There has been little research on temporomandibular joint (TMJ) dislocation after maxillary DO. We present these 3 cases and analyze the possible causes for reference by other clinicians. Read More

View Article and Full-Text PDF
February 2021

Bone regeneration in dentistry: an overview.

Authors:
G Ra Q Wo

J Biol Regul Homeost Agents 2021 Jan-Feb;35(1 Suppl. 1):37-46

Private practice, Chonqing.

Reconstructive surgery (RS) is necessary before implant placement to regenerate bone defects. Success rate of implants is related to RS and to the correct position of implants in residual crest. The most popular surgical procedures of RS are bone grafts, guided bone regeneration. Read More

View Article and Full-Text PDF
February 2021

Outcome of surgical-orthodontic treatment in hemifacial microsomia with and without early mandibular distraction osteogenesis.

Int J Oral Maxillofac Surg 2020 Nov 17. Epub 2020 Nov 17.

Graduate Institute of Dental and Craniofacial Science, Chang Gung University, Taoyuan, Taiwan; Craniofacial Research Centre, Chang Gung Memorial Hospital, Linkou, Taiwan; Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, Taipei, Taiwan. Electronic address:

The aim of this study was to compare the outcomes of surgical-orthodontic treatment between hemifacial microsomia (HFM) patients who had and had not undergone early mandibular distraction osteogenesis (DO). Twenty adult unilateral HFM patients were included, seven who had undergone early mandibular DO (DO group) and 13 who had not (NDO group). All patients were type IIB, except for one type IIA patient in the NDO group. Read More

View Article and Full-Text PDF
November 2020

Crouzon Syndrome and Acanthosis Nigricans With Fibrous Dysplasia of the Maxilla: An Unreported Suggested Triad.

J Craniofac Surg 2021 Jan-Feb 01;32(1):310-312

Hansjorg Wyss Department of Plastic Surgery, NYU Langone Medical Center, New York, NY.

Abstract: The aim of this report is to describe the combination of Crouzon syndrome and acanthosis nigricans with fibrous dysplasia of the maxilla. The diagnosis of fibrous dysplasia was confirmed clinically and pathologically during Le Fort III osteotomy and midface advancement with distraction osteogenesis. Crouzon syndrome with acanthosis nigricans is a known syndrome with an incidence of 1:1,000,000. Read More

View Article and Full-Text PDF
November 2020

Miniscrew-assisted single-tooth distraction osteogenesis to align an ankylosed infraoccluded maxillary central incisor: A case report.

J Orthod 2020 Dec 22;47(4):345-353. Epub 2020 Sep 22.

Department of Periodontics, Dental School, Islamic Azad University of Borujerd, Borujerd, Iran.

The ankylosis of permanent incisors is usually caused by trauma. In a growing patient, the ankylosed tooth fails to move along with the vertical growth of the remaining alveolar process, which results in an infraoccluded tooth, gingival margin disharmony and unaesthetic smile.This case report presents an 23-year-old female patient whose maxillary right central incisor (tooth number 11) had been traumatised eight years earlier. Read More

View Article and Full-Text PDF
December 2020

Interdental Distraction Osteogenesis in Unilateral Cleft Lip and Palate Patient with Wide Alveolar Cleft.

Bull Tokyo Dent Coll 2020 Sep 14;61(3):201-209. Epub 2020 Aug 14.

Department of Oral-Maxillofacial Surgery, Tokyo Dental College.

Alveolar bone grafting is routinely performed in repair of alveolar clefts. When the alveolar cleft is wider than 11 mm, however, the survival rate of the bone graft and prognosis are poor. Here, we describe successful orthodontic treatment using interdental distraction osteogenesis (IDO) with a tooth-tooth type distractor to reduce the width of the alveolar cleft in a patient with unilateral cleft lip and palate. Read More

View Article and Full-Text PDF
September 2020

[Surgical-associated expansion of the jaws with asymmetric deformations].

Stomatologiia (Mosk) 2020 ;99(4):33-42

S.M. Kirov Military Medical Academy, Ministry of Defense of the Russian Federation, St. Petersburg, Russia.

One of the most common abnormalities in the development of the jaw is the narrowing of the alveolar process of the maxilla. In childhood, the elimination of such a deformation is quite common. But with age, the only effective option is the inclusion of a surgical procedure in the rehabilitation plan. Read More

View Article and Full-Text PDF

Vertical Distraction for the Treatment of Congenital Syngnathia.

J Craniofac Surg 2020 Sep;31(6):e606-e608

Division of Plastic and Reconstructive Surgery, Keck School of Medicine, University of Southern California.

Congenital syngnathia is a very rare condition that presents with several unique challenges. There is no consensus on the best operative approach to manage this condition. Readhesion of surgically separated tissues is a relatively common occurrence. Read More

View Article and Full-Text PDF
September 2020

Minimally-invasive anterior maxillary distraction technique in patients with cleft lip and palate and maxillary deficiency: an evaluation of 106 patients.

Br J Oral Maxillofac Surg 2020 09 4;58(7):777-783. Epub 2020 Jun 4.

Founder of Cleft Children International (CCI), Zurich, Switzerland.

Our aim was to evaluate the feasibility of a minimally-invasive surgical technique for anterior maxillary distraction osteogenesis to correct maxillary hypoplasia in patients with clefts. A modified Y distractor was placed intraorally in 106 patients with cleft- associated maxillary deficiency to facilitate protraction of the maxilla. Subsequently the patients had an anterior maxillary osteotomy through a minimally invasive incision, followed by activation of the appliance at the rate of 0. Read More

View Article and Full-Text PDF
September 2020

Outcomes of Intracranial Versus Subcranial Approaches to the Frontofacial Skeleton.

J Oral Maxillofac Surg 2020 09 22;78(9):1609-1616. Epub 2020 Apr 22.

Chief, Division of Plastic and Reconstructive Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA; and Chief, Division of Plastic and Maxillofacial Surgery, Children's Hospital of Los Angeles, Los Angeles, CA.

Purpose: An intracranial approach to the craniomaxillofacial skeleton can be effective for correcting complex craniofacial dystoses such as frontofacial hypoplasia, hypertelorism, and orbital dystopia. However, the significant morbidity resulting from the high complication rates has limited intracranial use. Given the need for intracranial approaches for certain clinical indications, the present study reevaluated intracranial frontofacial procedures to determine their safety and outcomes. Read More

View Article and Full-Text PDF
September 2020

Skeletal stability in patients with clefts after large maxillary advancements using intraoral distraction.

Br J Oral Maxillofac Surg 2020 07 18;58(6):663-668. Epub 2020 May 18.

Department of Oral and Maxillofacial Surgery; Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.

Maxillary hypoplasia is a common outcome in patients with cleft lip and palate after surgical and orthodontic interventions, and maxillary distraction osteogenesis has become a useful procedure for patients with extensive maxillary deformities. The aim of this study was to evaluate long term (two years) stability after maxillary advancement of more than 10mm by distraction osteogenesis in cleft patients using internal devices. We organised a retrospective study on 42 patients with cleft lip and palate using cephalometric analysis before and after maxillary distraction osteogenesis and evaluated them for 24 months. Read More

View Article and Full-Text PDF

Skeletal Surgery for Obstructive Sleep Apnea.

Otolaryngol Clin North Am 2020 Jun 23;53(3):459-468. Epub 2020 Apr 23.

Division of Sleep Surgery, Department of Otolaryngology-Head & Neck Surgery, Stanford University, 801 Welch Road, Stanford, CA 94305, USA. Electronic address:

This article focuses on the role of skeletal surgery within the modified Stanford protocol with particular attention focused on the evolved role of MMA. First, surgery in patients presenting with congenital dentofacial deformity or characteristic drug-induced sleep endoscopy findings, then the growing role of maxillary expansion in a newly identified patient phenotype, and finally genioglossus advancement, are discussed. Less commonly used and validated techniques, such as isolated mandibular advancement and maxillomandibular expansion are not discussed in this article. Read More

View Article and Full-Text PDF

Leveling the Maxillary Occlusal Plane Without Orthodontic Appliances in Patients With Hemifacial Microsomia Using Unilateral Vertical Mandibular Distraction Osteogenesis.

J Craniofac Surg 2020 Jun;31(4):927-930

Division of Plastic and Reconstructive Surgery, University Hospitals, Cleveland, OH.

Purpose: To assess maxillary occlusal plane correction in patients with hemifacial microsomia (HFM) after vertical vector mandibular distraction osteogenesis (vMDO) without orthodontic appliances.

Methods: A retrospective study was performed on consecutive patients with HFM and Kaban-Pruzansky type-II mandibular deformities who underwent unilateral vMDO by a single surgeon over an 18-month period. Patients with 12-months minimum clinical follow-up and postero-anterior (PA) cephalograms taken preoperatively and at a minimum of 3 months post-consolidation were included. Read More

View Article and Full-Text PDF

A comparison of tooth-borne and bone-anchored expansion devices in SARME.

Oral Maxillofac Surg 2020 Jun 14;24(2):181-187. Epub 2020 Apr 14.

IAMSPE/HSPE, Avenida Ibirapuera 981, Sao Paulo, Sao Paulo, Brazil.

Purpose: Major adult maxillary transverse discrepancies are usually treated with surgically assisted rapid maxillary expansion (SARME), utilizing a combination of surgical and orthodontic techniques. Unfortunately, a consensus has not been reached on topics ranging from the best surgical technique that should be performed to the ideal expander type that should be installed. The present study sought to evaluate the efficiency and stability of the maxillary expansion achieved with two types of expanders following the same SARME procedure without pterygomaxillary disjunction (PMD). Read More

View Article and Full-Text PDF

Early hemi-mandibular lengthening by distraction osteogenesis contributes to compensatory maxillary growth.

J Craniomaxillofac Surg 2020 Apr 29;48(4):357-364. Epub 2020 Feb 29.

Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, 639 Zhizaoju Road, Shanghai, People's Republic of China. Electronic address:

Mandibular distraction osteogenesis at an early age is the standard hemifacial microsomia treatment. Nevertheless, the recurrence rate remains high and the definition of early age is controversial. We explored the optimal timing for mandibular distraction, when the surrounding skeleton, such as maxilla, can grow compensatory, to reduce recurrence. Read More

View Article and Full-Text PDF

A retrospective analysis of complications associated with tooth-borne anterior maxillary distraction for managing cleft maxillary hypoplasia: A 12-year experience.

J Craniomaxillofac Surg 2020 Apr 22;48(4):365-375. Epub 2020 Feb 22.

Richardson's Dental and Craniofacial Hospital, No 71, Trivandrum Highway, Chunkankadai, Parvathipuram, Nagercoil, Tamilnadu 629003, India; Goa Dental College and Hospital, Bambolim, Calapor 403202, India. Electronic address:

Purpose: To evaluate the intra- and post-operative complications of tooth-borne anterior maxillary distraction in management of cleft maxillary hypoplasia over a 12-year period, and to establish whether the procedure involves a learning curve.

Materials And Methods: All patients with cleft maxillary hypoplasia satisfying the inclusion and exclusion criteria and undergoing anterior maxillary distraction with a tooth-borne palatal distractor between June 2007 to June 2018 were retrospectively studied by retrieving their individual medical records, which included radiographic (lateral cephalogram analysis at three different intervals) and speech assessment records. The presence of intra- and post-operative complications developing in this study period was noted. Read More

View Article and Full-Text PDF

LeFort Distraction in the Cleft Patient.

Oral Maxillofac Surg Clin North Am 2020 May 6;32(2):269-281. Epub 2020 Mar 6.

Craniofacial Orthodontics, Seattle Children's Hospital, Craniofacial Center, M/S OB.9.520, 4800 Sand Point Way Northeast, Seattle, WA 98105, USA.

The cleft patient may present with significant maxillary deficiency requiring maxillary advancement to establish balanced facial form and function. Often these skeletal advancements require movement of the maxilla of more than 10 mm. The cleft patient poses special challenges because of difficulty of mobilizing tissues on a multiply operated maxilla, as well as long-term stability. Read More

View Article and Full-Text PDF

Complex orthodontic and surgical management of an adult patient with transverse maxillary deficiency and skeletal class III malocclusion: A case report.

Dent Med Probl 2020 Jan-Mar;57(1):103-109

Department of Maxillofacial Orthopedics and Orthodontics, Wroclaw Medical University, Poland.

Skeletal deformities constitute a relatively common structural and functional craniofacial abnormality. The chief complaints reported by patients include a lack of satisfaction with facial appearance, difficulty with breathing or eating, and altered speech. The management of skeletal malocclusion requires a complex orthodontic and surgical approach. Read More

View Article and Full-Text PDF
November 2020

Surgical-Orthodontic Considerations in Subcranial and Frontofacial Distraction.

Oral Maxillofac Surg Clin North Am 2020 May 23;32(2):309-320. Epub 2020 Feb 23.

Craniofacial Center, Divisions of Craniofacial and Plastic Surgery and Oral-Maxillofacial Surgery, Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA 98105, USA. Electronic address:

Subcranial and frontofacial distraction osteogenesis have emerged as powerful tools for management of hypoplasia involving the upper two-thirds of the face. The primary goal of subcranial or frontofacial distraction is to improve the orientation of the upper face and midface structures (frontal bone, orbitozygomatic complex, maxilla, nasal complex) relative to the cranial base, globes, and mandible. The various techniques used are tailored for management of specific phenotypic differences in facial position and may include segmental osteotomies, differential vectors, or synchronous maxillomandibular rotation. Read More

View Article and Full-Text PDF

Creation of Bone and Soft Tissue in Postmaxillectomy Patients Using Curvilinear Transport Distraction Osteogenesis.

Ann Maxillofac Surg 2019 Jul-Dec;9(2):319-325

Department of Mechanical Engineering, University of Cape Town, Rondebosch, South Africa.

Background: Large surgical defects in the maxilla due to trauma or tumor are usually reconstructed with revascularized-free fibula flaps (RFFF). In the past, the use of curvilinear transport distraction osteogenesis (CTDO) has been shown to be an efficacious way in closing large defects in the maxilla, but it had limitations which have now been overcome by the present development. The present distractor is an improvement upon the previous three prototypes and employs the concept of tetrafocal distraction by means of hybridizing the bone with the tooth in the transport disc segment. Read More

View Article and Full-Text PDF
January 2020

Unique mishap following transfacial pin fixated midface distraction and successful management using nasal endoscopy.

BMJ Case Rep 2019 Dec 23;12(12). Epub 2019 Dec 23.

Anesthesia, Kanchi Kamakoti Childs Trust Hospital, Nungambakkam, Tamil Nadu, India.

A 2-year-old female child with craniosynostosis was referred to our unit for definitive management. She presented with a turricephalic head, hypoplastic midface and obstructive sleep apnoea. Routine preoperative workup included radiographs, CT and polysomnography. Read More

View Article and Full-Text PDF
December 2019

Maxillomandibular and occlusal relationships in preadolescent patients with syndromic craniosynostosis treated by LeFort III distraction osteogenesis: 10-year surgical and phenotypic stability.

Am J Orthod Dentofacial Orthop 2019 Dec;156(6):779-790

Wyss Department of Plastic Surgery, New York University, Langone Medical Center, New York, NY. Electronic address:

Introduction: LeFort III distraction osteogenesis may be indicated in the treatment of syndromic craniosynostosis with severe midface retrusion. This study investigates long-term changes in patients undergoing distraction as children, and compares outcomes to an unaffected, untreated control.

Methods: Fifteen patients (9 males, 6 females) with syndromic craniosynostosis treated by LeFort III distraction at an average age of 4. Read More

View Article and Full-Text PDF
December 2019

An Objective Assessment of Orthognathic Surgery Patients.

J Craniofac Surg 2019 Nov-Dec;30(8):2479-2482

Department of Oral and Maxillofacial Surgery, The Herman Ostrow School of Dentistry, Los Angeles County/USC Medical Center, University of Southern California, Los Angeles, CA.

Objectives: To retrospectively assess malocclusions, skeletal relationships and the functional needs of orthognathic patients treated in a University teaching hospital.

Subjects And Methods: This study used clinical records of 100 consecutive patients [51 female, 49 males, mean (SD) age =21.5 (2. Read More

View Article and Full-Text PDF
January 2020