Effect of Mandibular Distraction on the Temporomandibular Joint

Evaluation of alveolar nerve function after surgical lengthening of the mandible by a bilateral sagittal split osteotomy or distraction osteogenesis

“…Condylar resorption, which can result in relapse, is assumed to be less with DO due to gradual stretching of the soft tissues and loading of the condyles. In animal studies, more condylar changes can be seen when the distraction rhythm is increased, probably due to more compressive forces 12,21,31 . Patients with a high mandibular plane angle are probably at risk of relapse after a DO 27 .…”

Distraction osteogenesis versus bilateral sagittal split osteotomy for advancement of the retrognathic mandible: a review of the literature

“…There is still discussion about the aetiology of PCR occurring after BSSO, reflected by the many influencing factors that have been mentioned in the literature 1,9,30,54,58,75 . Although distraction rates not exceeding 1 mm/day seemed to be within the physiological capacity of the temporomandibular joint, thus causing reversible injury, this has not been proven in human studies 51,52,89,106 .…”

“…PCR may occur when certain stresses, in this case due to advancement surgery, are exerted on the articular structures that exceed normal or decreased adaptive capacity 1 . Forces needed to distract the two mandibular fragments during DO might act as a compressive force on distant sites such as the temporomandibular joint 45,52,89 . The loading of the condyles caused by these forces during distraction of 1 mm/day is thought to be gradual, instead of acute, which might prevent or decrease the risk of development of PCR 51,52,83,89,106 , as occasionally observed after BSSO 1,9,30,54,58,75 .…”

The effect of irradiation and hyperbaric oxygenation (HBO) on extracellular matrix of the condylar cartilage after mandibular distraction osteogenesis in the rabbit

“…The morphology of a deformed TMJ may even be improved as a result of DO treatment 8,15 . After unilateral mandibular DO the cartilaginous alterations are most prominent on the distracted side where the pressure created against the TMJ is greatest 8 .…”