Al-Mahdi Akmam H, Al-Jumaily Hassanien Ahmed Hadi
Medical City Hospital in Iraq, and Arab Board Council in Iraq.
J Craniofac Surg. 2013 Jan;24(1):e50-7. doi: 10.1097/SCS.0b013e3182700223.
Mandibular hypoplasia is one of the most frequently encountered craniofacial anomalies with a variety of etiologies, including congenital, developmental, and acquired. It can lead to significant functional issues at birth by creating an obstruction of the hypopharynx with the retropositioning of the base of the tongue, which lead to respiratory and feeding difficulties at birth. Later in life, mandibular hypoplasia may have a severe impact on the quality of life of the patient, affecting mastication, speech, and appearance. Distraction osteogenesis (DO) of the craniofacial skeleton emerged as an alternative to orthognathic surgery. It is a topic of great interest; the technique is gaining enthusiasm for the treatment of a wide range of deformities and achieved wide acceptance in orthopedics.
The objective of the study was to determine the changes in overbite, overjet, and midline shift following mandibular DO in Iraqi patients.
Nine patients (3 males and 6 females) underwent extraoral multidirectional mandibular DO after proper clinical evaluation. After performing the corticotomy and a mean of 5-day latency period, the distraction was performed at a rate of 0.5 mm twice a day. Subsequent consolidation period mean was 2 months.
The mandible was successfully elongated in 9 patients with significant decrease in overbite, overjet, and midline shift, and the actual horizontal movement needed in the correction of overjet is more than the horizontal distractor lengthening.
下颌骨发育不全是最常见的颅面畸形之一,病因多样,包括先天性、发育性和后天性。它可在出生时因舌根后移导致下咽梗阻,从而引起呼吸和喂养困难,导致严重的功能问题。在患者后期生活中,下颌骨发育不全可能对患者的生活质量产生严重影响,影响咀嚼、言语和外貌。颅面骨骼的牵张成骨术(DO)已成为正颌手术的替代方法。这是一个备受关注的话题;该技术在治疗各种畸形方面越来越受到青睐,并在整形外科中得到广泛认可。
本研究的目的是确定伊拉克患者下颌骨DO术后覆牙合、覆盖和中线偏移的变化。
9例患者(3例男性,6例女性)在经过适当的临床评估后接受了口外多向下颌骨DO。在进行皮质切开术并平均延迟5天后,以每天0.5毫米的速度分两次进行牵张。随后的巩固期平均为2个月。
9例患者下颌骨成功延长,覆牙合、覆盖和中线偏移显著减少,矫正覆盖所需的实际水平移动大于水平牵张器延长的长度。