Mandibular widening by intraoral distraction osteogenesis

Guerrero, C.; Bell, W. H.; Contasti, G.I.; Rodríguez, Aura M.

doi:10.1016/s0266-4356(97)90712-9

Cited by 224 publications

(125 citation statements)

References 6 publications

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“…The authors suggested that it was caused by radicular surface exposure, resulting from inter-dental osteotomies in narrow inter-dental spaces (Bell et al, , 1999. When a true latency period of 5e7 days was respected, crestal bone loss was not observed and the attached gingiva maintained its preoperative level (Guerrero et al, 1997;Kewitt and Van Sickels, 1999;Niederhagen et al, 1999;Mommaerts et al, 2005). These findings, and the ones from the present experiment, suggest that keeping the junctional epithelium attached, or allowing its reattachment, may be more important than keeping bone on the roots.…”

Section: Discussionsupporting

confidence: 59%

“…Indeed, an inter-dental osteotomy is required and besides its morbidity, permanent damage to the periodontium and teeth may occur. In animal experiments (Bell et al, , 1999Del Santo et al, 2000) and clinical investigations (Guerrero et al, 1997;Weil et al, 1997;Kewitt and Van Sickels, 1999;Cope et al, 2002) inter-dental callus formation and tooth movements were studied, and occasionally accidental damage to teeth and periodontal structures was reported. Mommaerts et al (2005) described the periodontal status and tooth vitality changes during the distraction and consolidation phase more in depth in a clinical study.…”

Section: Introductionmentioning

confidence: 99%

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Periodontal impact of surgically induced dental lesions in mandibular osteodistraction: An animal study

Correia

Wehrbein

Mommaerts

2009

Journal of Cranio-Maxillofacial Surgery

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SUMMARY. Aim: The objective of the study was to evaluate the impact of dental lesions on the periodontium, in a canine model of mandibular osteodistraction. Material and methods: In six adult male Beagle dogs, an osteotomy was made between the right second lateral incisor and canine, and a distraction device placed. The roots adjacent to the osteotomy were deliberately damaged by the reciprocating saw and chisel, with preservation of the attached gingiva. The osteodistraction protocol used was: latency of 7 days, rate of distraction 1 mm per day, and rhythm once a day for 5 days. Vital staining was carried out with tetracycline, Xylenol Orange and Calcein Green. The dogs were sacrificed after 12 weeks of consolidation and the specimens were evaluated with light microscopy (native, polarized light, fluorescence, and after toluidin blue staining). Results: The periodontal ligament (PDL) regeneration was observed in the 2500 slices examined. Cementum and dentine lesions were repaired by cellular cementum. Loose dentine and cementumedentine fragments were embedded in regenerated PDL and their surface repaired by cementum. By means of light microscopic examination and within the limited observation time, no degenerative pulpal changes were found, when the pulp canal was not entered. Extensive pulp exposure and destruction resulted in ingrowth of the PDL and bone-like tissue. In that case, cellular cementum also lined the dentine surface of the pulp canal. Conclusion: Although there was an extensive reparative response to the para-pulpal lesions, none of the changes observed showed evidence of a loss of functional integrity of the periodontium at the distraction site. The fate of the tooth with exposed pulp canal remains uncertain. Ó 2008 European Association for Cranio-Maxillofacial Surgery

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Section: Discussionsupporting

confidence: 59%

Section: Introductionmentioning

confidence: 99%

Periodontal impact of surgically induced dental lesions in mandibular osteodistraction: An animal study

Correia

Wehrbein

Mommaerts

2009

Journal of Cranio-Maxillofacial Surgery

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“…Several clinical studies report the promising results obtained from patients treated with mandibular distraction osteogenesis [16,19,20,51]. During a typical mandibular distraction osteogenesis procedure, the mandible is first osteotomized and then instrumented by applying a distraction orthodontic device.…”

Section: Introductionmentioning

confidence: 99%

Tissue differentiation and bone regeneration in an osteotomized mandible: a computational analysis of the latency period

Boccaccio

Prendergast

Pappalettere

et al. 2007

Med Biol Eng Comput

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Mandibular symphyseal distraction osteogenesis is a common clinical procedure to modify the geometrical shape of the mandible for correcting problems of dental overcrowding and arch shrinkage. In spite of consolidated clinical use, questions remain concerning the optimal latency period and the influence of mastication loading on osteogenesis within the callus prior to the first distraction of the mandible. This work utilized a mechano-regulation model to assess bone regeneration within the callus of an osteotomized mandible. A 3D model of the mandible was reconstructed from CT scan data and meshed using poroelastic finite elements. The stimulus regulating tissue differentiation within the callus was hypothesized to be a function of the strain and fluid flow computed by the finite element model. This model was then used to analyse tissue differentiation during a fifteen day latency period, defined as the time between the day of the osteotomy and the day when the first distraction is given to the device. The following predictions are made: (i) the mastication forces generated during the latency period support osteogenesis in certain regions of the callus, and that during the latency period the percentage of progenitor cells differentiating into osteoblasts increases; (ii) reducing the mastication load by 70% during the latency period increases the number of progenitor cells differentiating into osteoblasts; (iii) the stiffness of new tissue increases at a slower rate on the side of bone callus next to the occlusion of the mandibular ramus which could cause asymmetries in the bone tissue formation with respect to the middle sagittal plane. Although the model predicts that the mastication loading generates such asymmetries, their effects on the spatial distribution of callus mechanical properties are insignificant for typical latency periods used clinically. It is also predicted that a latency period of longer than a week will increase the risk of premature bone union across the callus.

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“…They include dental extractions, interproximal reduction and orthodontic compensation. The last option could damage the periodontium, particularly if there is a vestibuloversion of the lower anterior teeth, because it forces the teeth out of their alveolar bone 14 . Using intermaxillary elastics to create a vestibuloversion of the mandibular molars and a linguoversion of the maxillary molars also has a role in our therapeutic arsenal 19 .…”

Section: Treatment Optionsmentioning

confidence: 99%