Robiony Massimo
Department of Maxillofacial, Surgery University of Udine, Italy.
J Craniofac Surg. 2010 Mar;21(2):508-12. doi: 10.1097/SCS.0b013e3181d02391.
Distraction osteogenesis is a well-established surgical procedure to elongate the maxillofacial skeleton. The authors propose a new method to balance facial asymmetry by means of distraction of the inferior borders of the mandible, without change of the occlusion, using an alveolar device. Nine patients with asymmetry were treated. Records included panoramic radiographs and computed tomographic scans. Preoperatively, stereolithographic models and virtual-reality surgery were performed to have a precise surgical planning. The surgical procedure was based on segmental inferior osteotomy and simultaneous positioning of the alveolar device upside-down. Postoperative clinical evaluation demonstrated that a very impressive elongation of the inferior bony border with simultaneous expansion of the soft tissues had been achieved, resulting in a satisfying facial balance. The postdistraction radiographs showed the ossification of the gap, and the new bone formation was observed and confirmed by biopsy. Distraction osteogenesis of the inferior border of the mandible and the chin represents a new method to correct facial asymmetry and is a valid alternative to the traditional techniques. In addition, surgical virtual reality and stereolithographic models are, without a doubt, an advantage in defining the vector of distraction and in simulating the final result.
牵引成骨术是一种成熟的用于延长颌面骨骼的外科手术。作者提出了一种新方法，通过使用牙槽装置牵引下颌下缘来平衡面部不对称，而不改变咬合关系。对9例不对称患者进行了治疗。记录包括全景X线片和计算机断层扫描。术前进行了立体光刻模型和虚拟现实手术，以制定精确的手术计划。手术过程基于节段性下颌下截骨术和牙槽装置的倒置同步定位。术后临床评估表明，下颌骨下缘实现了非常显著的延长，并同时伴有软组织扩张，从而获得了令人满意的面部平衡效果。牵引后X线片显示间隙骨化，通过活检观察并证实了新骨形成。下颌下缘和下巴的牵引成骨术是一种纠正面部不对称的新方法，是传统技术的有效替代方案。此外，手术虚拟现实和立体光刻模型无疑在确定牵引向量和模拟最终结果方面具有优势。
