A new approach to repairing cleft palate and acquired palatal defects with distraction osteogenesis

Wang, D.-Z.; Chen, G.; Liao, Ying; Liu, S.-G.; Gao, Zhan; Hu, Jing; Li, J.-H.; Liao, Chun-hui

doi:10.1016/j.ijom.2006.03.010

Cited by 9 publications

(4 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Experimental animal studies have shown that alveolar and palatal full-thickness defects could be successfully closed with bone transport distraction 1516. Several authors achieved the same objectives while treating patients with alveolar and palatal cleft, obtaining good functional results, and also showed that superior aesthetical dental rehabilitation is possible with implants and orthodontic treatment 1011171819.…”

Section: Discussionmentioning

confidence: 96%

Immediate Reconstruction of Large Full-Thickness Segmental Anterior Maxillary Defect with Bone Transport

Pereira

Montezuma

Oliveira

et al. 2016

Craniomaxillofacial Trauma & Reconstruction

View full text Add to dashboard Cite

Maxillary segmental defects are a reconstructive challenge particularly when the anterior arch is involved. Missing bone, mucosa, and teeth should be replaced; fistulae closure should be guaranteed by bone and mucosa continuity; stable functional occlusion should be achieved; and facial aesthetics restored. These defects resulting from tumor excisions, if left untreated, will cause additional problems related to interposed scar and collapse of lip and nose. Immediate reconstruction should avoid these problems and should be considered when safe tumor-free margins are obtained. This study describes the treatment of such a defect resulting from a myxoma excision, with trifocal distraction requiring only one additional surgery. Internal distractors were fixed bilaterally for transport of two segmental discs created by inverted L osteotomies at the same surgical time of tumor excision. A second surgery was performed after central contact between transport discs was achieved, for device removal and creation of a dynamic system to regenerate molding and compression-focus development. This was accomplished by internal fixation of one side and central fixation of a full-open distractor to act as compression device when reversely activated. Central perfect adaptation between transported segments and good-quality attached mucosa lining the alveolar crest were determinant to obtain a stable functional and aesthetic result.

show abstract

Section: Discussionmentioning

confidence: 96%

Immediate Reconstruction of Large Full-Thickness Segmental Anterior Maxillary Defect with Bone Transport

Pereira

Montezuma

Oliveira

et al. 2016

Craniomaxillofacial Trauma & Reconstruction

View full text Add to dashboard Cite

show abstract

“…Another animal study done by Wang et al (2006) with feline maxillary transport distraction demonstrated intramembranous bone formation with parallel collagen bundles gradually deposited on new bone trabeculae while the proliferative osteoblasts produced bone matrix. The bone defect was finally reconstructed by de novo osteogenesis, and the soft tissues expanded simultaneously to achieve functional correction.…”

Section: Discussionmentioning

confidence: 98%

Three-Dimensional Reconstruction of Large Secondary Alveolar Cleft by Two-Stage Distraction

Rachmiel

Emodi

Aizenbud

2014

The Cleft Palate-Craniofacial Journal

View full text Add to dashboard Cite

show abstract

“…[26][27][28] The successful completion of new bone formation and construction depends on combined actions of multilevel factors in the surrounding environment, including biomechanical stimulation, cytokines, related enzymes and proteins, extracellular matrix proteins, and the expression of various transcription factors as well as the interactions among different genes that control and coordinate the synthesis of these molecules. 29,30 The IGF-I, bone morphogenetic proteins (BMPs), transforming growth factor (TGF)-β, and basic fibroblast growth factor are all growth factors associated with new bone formation.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Genetic Regulation and Cytokine Expressions of Distraction Osteogenesis Reconstruction for Cleft Palate

Bai¹,

Liu²,

Chen³

et al. 2014

Journal of Craniofacial Surgery

View full text Add to dashboard Cite

Because cleft palate (CP) is one of the most common congenital deformities, surgeons have tried for longtime to achieve an ideal reconstruction of the palatal bone defects and restoration of muscle attachments. In this study, a new CP model on rhesus was established and corrected by an approach of distraction osteogenesis (DO), and then quantitative studies of regulation of osteogenesis genes and expression of alkaline phosphatase (ALP), insulin-like growth factor-I (IGF-I), osteopontin (OPN), and osteocalcin (OC) in different phases of new bone formation were preformed. The CP models (23 animals) were established surgically. In the experimental group (21 animals), the tissue defects were repaired by means of DO at the rhythm of 0.4 mm twice per day. The specimens were retrieved in 1, 2, 4, 6, 8, 12, and 24 weeks (3 animals each) after completion of distraction. The IGF-I, ALP, OPN, and OC messenger RNA (mRNA) were detected by real-time reverse transcription polymerase chain reaction, and their proteins were then analyzed by enzymelinked immunosorbent assay tests. The results are compared with those of the experimental control and empty control groups (2 animals each). In the distraction gap, the mRNA and protein expressions levels of IGF-I and ALP were both highly upregulated and reaching apex in the early phase of new bone formation. Otherwise, the mRNA and protein expressions of OPN and OC demonstrated high level during intermediate and later remodeling stages. These results suggest that the reconstruction of CP bone defect by means of DO could get definitely intramembraneous new bone formation and eventually quite normal bone structure via consecutive remodeling in situ.O steoblastic activities are generally divided into 3 phases, which include period of differentiation and proliferation, period of extracellular matrix formation and maturation, and period of extracellular matrix calcification. 1 Cell-type-specific and differentiationstage-specific expressions of alkaline phosphatase (ALP), insulin-like growth factor-I (IGF-I), osteopontin (OPN), and osteocalcin (OC) give valuable insights into the differentiation stages of osteogenic cells and also into the origin of the cells involved in distraction osteogenesis (DO). 2-4 Using quantitative measurement of messenger RNA (mRNA) and protein levels of these markers, we cannot only explain the state of cell func0tion and structural components of extracellular matrix changes in trends and characteristics, which in various stages of DO treatment of cleft palate (CP) and acquired palatal bone defects, but also explore the potential relationship between them. 5-7 Because these 2 different levels have respective characteristics, the results should supplement and confirm each other.Currently, surgical repair of soft palate tissues contribute to scar formation, soft palate shortening, and subsequent velopharyngeal insufficiency. These complications often necessitate further invasive procedures, thereby decreasing the need for secondary reconstructive procedures. 8,9 The...

show abstract

A new approach to repairing cleft palate and acquired palatal defects with distraction osteogenesis

Cited by 9 publications

References 29 publications

Immediate Reconstruction of Large Full-Thickness Segmental Anterior Maxillary Defect with Bone Transport

Immediate Reconstruction of Large Full-Thickness Segmental Anterior Maxillary Defect with Bone Transport

Three-Dimensional Reconstruction of Large Secondary Alveolar Cleft by Two-Stage Distraction

Analysis of Genetic Regulation and Cytokine Expressions of Distraction Osteogenesis Reconstruction for Cleft Palate

Contact Info

Product

Resources

About