Chopra Shamit, Enepekides Danny J
Department of Otolaryngology - Head and Neck Surgery, University of California - Davis Medical Center, Sacramento, California 95817, USA.
Curr Opin Otolaryngol Head Neck Surg. 2007 Aug;15(4):197-201. doi: 10.1097/MOO.0b013e3282495925.
Distraction osteogenesis is finding increasing application in the management of mandibular defects. It provides an alternative method of mandibular reconstruction in varied clinical settings, notably following trauma and ablation of malignant tumors. Many recent studies have explored modifications in surgical technique, refinements in device design, and experiments in animal models. This review attempts to discuss all of the above.
In addition to managing the segmental mandibular gap, the vertical distraction technique is highly useful for increasing fibular bony height, allowing osseointegrated implant placement and dental rehabilitation. Variations in distraction planes, parameters and device placement have made it possible to tailor appropriate reconstructive strategies to the specific patient. Newer developments in distractor design and constituents, and the application of staged distraction procedures, have facilitated optimal management of the challenging defect.
Distraction osteogenesis is a continually evolving field of research and study, and an aesthetically and functionally acceptable option for managing extensive mandibular defects, and those not amenable to conventional methods. It offers distinct advantages over other available reconstructive options, but does have its disadvantages. With further improvement in devices and technique, it has the potential of being much more widely used in the future.
牵张成骨在下颌骨缺损的治疗中应用日益广泛。它为不同临床情况下的下颌骨重建提供了一种替代方法，尤其是在创伤后以及恶性肿瘤切除术后。最近许多研究探讨了手术技术的改进、器械设计的优化以及动物模型实验。本综述试图对上述所有内容进行讨论。
除了处理节段性下颌骨间隙外，垂直牵张技术对于增加腓骨骨高度非常有用，可实现骨整合种植体植入和牙齿修复。牵张平面、参数和器械放置的变化使得能够为特定患者量身定制合适的重建策略。牵张器设计和组件的新进展以及分期牵张程序的应用，有助于对具有挑战性的缺损进行最佳处理。
牵张成骨是一个不断发展的研究领域，是治疗广泛下颌骨缺损以及那些不适用于传统方法的缺损的一种在美学和功能上可接受的选择。它相对于其他可用的重建选择具有明显优势，但也有其缺点。随着器械和技术的进一步改进，它未来有可能得到更广泛的应用。
