Molina Fernando
Department of Plastic and Reconstructive Surgery, Postgraduate Division of the Medical School, Universidad Nacional Autonoma de Mexico and the Hospital General, Dr Manuel Gea Gonzalez, SS, Mexico City, Mexico.
J Craniofac Surg. 2009 Sep;20 Suppl 2:1794-800. doi: 10.1097/SCS.0b013e3181b5d4de.
Mandibular distraction is the treatment of choice for the surgical correction of mandibular hypoplasia of different etiology. It is a surgical technique that is less invasive and time intensive; also, it has a significantly decreased morbidity rate.The experience of lengthening mandibles in the last 17 years had shown that in more severe mandibular hypoplasia, better results will be obtained in the long term with earlier treatment, especially in the more severe grades of hemifacial microsomia types IIB and III. Orthodontics plays a very important role to correct postdistruction occlusal changes and to promote a balanced growth.Besides the impressive aesthetic and functional results obtained in most cases, undoubtedly, the simultaneous expansion of the overlying soft tissues is the mayor advantage of this technique when it is compared with conventional osteotomies.With this clinical experience in the mandible using distraction osteogenesis, we confirm the farewell to major osteotomies to treat a wide range of deformities of this sophisticate anatomic structure.
下颌骨牵张成骨术是外科矫正不同病因所致下颌骨发育不全的首选治疗方法。它是一种侵入性较小且耗时较短的外科技术；此外，其发病率显著降低。过去17年中延长下颌骨的经验表明，在更严重的下颌骨发育不全病例中，早期治疗从长期来看会取得更好的效果，尤其是在IIB型和III型更严重的半侧颜面短小畸形病例中。正畸治疗在纠正牵张成骨术后的咬合变化以及促进均衡生长方面发挥着非常重要的作用。除了在大多数病例中获得令人印象深刻的美学和功能效果外，与传统截骨术相比，毫无疑问，该技术同时对上颌软组织的扩张是其主要优势。基于在下颌骨应用牵张成骨术的临床经验，我们证实告别大型截骨术来治疗这种复杂解剖结构的广泛畸形。
