Lucchese Alessandra, Manuelli Maurizio, Albertini Paolo, Asperio Paolo, Gastaldi Giorgio
Department of Orthodontics, Vita Salute, San Raffaele University.
Unit of Dentistry, Division of Orthodontics, Research Area in Dentofacial Orthopedics and Orthodontics, IRCCS San Raffaele Scientific Institute, Milan.
J Craniofac Surg. 2018 Jun;29(4):970-972. doi: 10.1097/SCS.0000000000004223.
Distraction osteogenesis (DO) is a technique that allows the generation of new bone in a gap between 2 vascularized bone surfaces in response to the application of graduated tensile stress across the bone gap.Distraction osteogenesis has become a routine treatment of choice to correct skeletal deformities and severe bone defects in the craniofacial complex over the past decade. Distraction osteogenesis has been successfully chosen in lengthening the maxilla and the mandible; in the maxilla and recently in the mandible, the jawbones have been distracted and widened transversely to relieve severe anterior dental crowding and transverse discrepancies between the dental arches.Distraction osteogenesis for maxillary advancement started in 1993 and is now widely used, especially in patients with skeletal Class III malocclusion caused by maxillary hypoplasia.The aim of this study was to present the efficiency of combined orthodontic and DO in the severe maxillary hypoplasia.A 35-year-old Italian man presented to our clinical practice with the chief complaint of esthetic and functionally problems because of skeletal Class III malocclusion with anterior crossbite.Considering that the severity of the skeletal discrepancy is remarkable but compensated by the DO potential, the combined orthodontic and DO treatment was considered adequate, like less invasive and equally effective.It was obtained a good alignment with the upper and lower arch dental alveolar maxillary advancement that allowed to correct the sagittal relationships.The patient was satisfied for the treatment results and had considerable improvement in his self-esteem.
牵张成骨术（DO）是一种技术，它能够在两个有血运的骨表面之间的间隙中生成新骨，这是对跨越骨间隙施加逐渐增加的拉应力的反应。在过去十年中，牵张成骨术已成为矫治颅面复合体骨骼畸形和严重骨缺损的常规首选治疗方法。牵张成骨术已成功应用于上颌骨和下颌骨的延长；在上颌骨以及最近在下颌骨，颌骨已被牵张并横向增宽，以缓解严重的前牙拥挤和牙弓之间的横向差异。上颌骨前移的牵张成骨术始于1993年，现在已广泛应用，尤其是在由上颌骨发育不全引起的骨骼III类错牙合患者中。本研究的目的是展示正畸与牵张成骨术联合治疗严重上颌骨发育不全的疗效。一名35岁的意大利男子因骨骼III类错牙合伴前牙反牙合导致美观和功能问题前来我们的临床就诊。考虑到骨骼差异的严重程度显著，但牵张成骨术有潜在的代偿作用，正畸与牵张成骨术联合治疗被认为是合适的，因为其侵入性较小且效果相同。通过上颌牙槽骨的上下牙弓前移获得了良好的排齐，从而纠正了矢状关系。患者对治疗结果满意，自尊心有了显著提高。
