Haddad Ibrahim, Khalil Ali
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Tishreen University, Lattakia, Syria.
Ann Med Surg (Lond). 2023 Jun 17;85(8):3938-3942. doi: 10.1097/MS9.0000000000000983. eCollection 2023 Aug.
Restoration of the segmental defects of the maxilla presents a reconstructive dare to obtain a perfect osseous form and height. A variety of prosthetic and surgical bone grafts exists, that produces less than optimal results. Bone transport distraction is a dependable procedure in several maxillofacial bone defects reconstruction techniques. This study aimed to evaluate the effectiveness of horizontal distraction osteogenesis (DO) using expansion screws for the treatment of atrophic and deficient bone, which is caused by acquired malformations.
A total of eight patients ( age 17-36 years) who came with atrophy of the maxilla were treated by horizontal DO. The used device consisted of two parts: one was an orthodontic expander and the other was a screw-ring. The expansion screws were set on the transport bone, which was osteotomized and fixed to the segments using microscrews. Radiographical documentation of the patients was obtained with cone beam computed tomography prior to the surgery and after 4 months of the distraction phase.
The average of the actual bone gain at the end of the consolidation period was 7 mm (range 5-9 mm). Intraoral DO failed in one patient. The average bone density in the distraction gap after 4 months of the DO was 460.40. The average bone density of the bone defect region after 4 months of the DO was 487.90.
Our results confirm that horizontal DO using expansion screws is a predictable and effective regenerative procedure for patients with acquired bone defects in the jaw.
上颌骨节段性缺损的修复是一项重建挑战，旨在获得完美的骨形态和高度。现有的多种修复性和外科骨移植方法，效果均不尽人意。在多种颌面骨缺损重建技术中，骨运输牵张成骨是一种可靠的方法。本研究旨在评估使用扩张螺钉进行水平牵张成骨（DO）治疗后天畸形所致萎缩性和骨量不足骨的有效性。
共有8例（年龄17 - 36岁）上颌骨萎缩患者接受了水平DO治疗。所使用的装置由两部分组成：一部分是正畸扩弓器，另一部分是螺圈。扩张螺钉置于运输骨上，运输骨行截骨术并用微型螺钉固定于各节段。术前及牵张期4个月后，通过锥形束计算机断层扫描获取患者的影像学资料。
巩固期结束时实际骨增量的平均值为7毫米（范围5 - 9毫米）。1例患者口腔内DO失败。DO 4个月后牵张间隙的平均骨密度为460.40。DO 4个月后骨缺损区域的平均骨密度为487.90。
我们的结果证实，对于颌骨后天性骨缺损患者，使用扩张螺钉进行水平DO是一种可预测且有效的再生方法。
