Update on mandibular distraction osteogenesis

Earley, Marisa; Butts, Sydney C.

doi:10.1097/moo.0000000000000067

Cited by 21 publications

(10 citation statements)

References 29 publications

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“…Recently, it has been shown that stromal cell-derived factor-1 facilitates migration of endogenous MSCs in vitro and in vivo , which makes it a potential target that can be manipulated to upregulate an ongoing endogenous process. Moreover, the use of BMP and FGF along with transplantation of MSCs dramatically improves outcomes in osteogenic distraction compared to the cell transplant alone (Earley & Butts, 2014). …”

Section: Stem Cells In Mandible and Tongue Regenerationmentioning

confidence: 99%

Mandible and Tongue Development

Parada

Chai

2015

Current Topics in Developmental Biology

133

142

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The tongue and mandible have common origins. They arise simultaneously from the mandibular arch and are coordinated in their development and growth, which is evident from several clinical conditions such as Pierre Robin sequence. Here, we review in detail the molecular networks controlling both mandible and tongue development. We also discuss their mechanical relationship and evolution as well as the potential for stem cell-based therapies for disorders affecting these organs.

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Section: Stem Cells In Mandible and Tongue Regenerationmentioning

confidence: 99%

Mandible and Tongue Development

Parada

Chai

2015

Current Topics in Developmental Biology

133

142

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“…Distraction osteogenesis is a lengthy and risky procedure that can result in post-operative non-union, infection, bleeding and device failure. Any of these complications ultimately prolong the period of treatment [25].…”

Section: Introductionmentioning

confidence: 99%

“…Mandibular distraction osteogenesis (MDO) and alveolar distraction osteogenesis are among many surgical techniques that have been studied using Göttingen Minipigs [23, 26–32]. Even more important has been the search for methodologies to enhance the process of distraction by accelerating the rates of activation and bone healing or to promote the osseointegration of bony implants utilizing novel biomaterials, implant coatings, growth factors such as morphogenetic proteins, angiogenic factors and autologous mesenchymal stem cells [22, 23, 25, 33, 34].…”

Section: Introductionmentioning

confidence: 99%

Cephalometric studies of the mandible, its masticatory muscles and vasculature of growing Göttingen Minipigs—A comparative anatomical study to refine experimental mandibular surgery

et al. 2019

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Over many decades, the Göttingen Minipig has been used as a large animal model in experimental surgical research of the mandible. Recently several authors have raised concerns over the use of the Göttingen Minipig in this research area, observing problems with post-operative wound healing and loosening implants. To reduce these complications during and after surgery and to improve animal welfare in mandibular surgery research, the present study elucidated how comparable the mandible of minipigs is to that of humans and whether these complications could be caused by specific anatomical characteristics of the minipigs’ mandible, its masticatory muscles and associated vasculature. Twenty-two mandibular cephalometric parameters were measured on CT scans of Göttingen Minipigs aged between 12 and 21 months. Ultimately, we compared this data with human data reported in the scientific literature. In addition, image segmentation was used to determine the masticatory muscle morphology and the configuration of the mandibular blood vessels. Compared to data of humans, significant differences in the mandibular anatomy of minipigs were found. Of the 22 parameters measured only four were found to be highly comparable, whilst the others were not. The 3D examinations of the minipigs vasculature showed a very prominent deep facial vein directly medial to the mandibular ramus and potentially interfering with the sectional plane of mandibular distraction osteogenesis. Damage to this vessel could result in inaccessible bleeding. The findings of this study suggest that Göttingen Minipigs are not ideal animal models for experimental mandibular surgery research. Nevertheless if these minipigs are used the authors recommend that radiographic techniques, such as computed tomography, be used in the specific planning procedures for the mandibular surgical experiments. In addition, it is advisable to choose suitable age groups and customize implants based on the mandibular dimensions reported in this study.

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“…[4] Thus, the pre-operational preparation of surgery guides is very important. [5] Most of the surgery guides used for mandibular distraction osteogenesis are hand-made, and so may carry disadvantages like poor dimensional accuracy, easy deformation, and long processing time, that do not meet the requirements of clinical use. Three-dimensional (3D) printing has several advantages for this purpose, including digitalization, flexibility, and customization during the fabrication process, all of which may improve dimensional accuracy and reduce complications.…”

Section: Introductionmentioning

confidence: 99%

Three-dimensional printing of surgical guides for mandibular distraction osteogenesis in infancy

2019

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Pierre Robin sequence (PRS) is a congenital malformation characterized by micrognathia, glossocoma, and mechanical obstruction of the upper respiratory tract. These deformities impair respiration, sleep, feeding, and swallowing, and can lead to malnutrition, stunted development, and death. Bilateral mandibular distraction osteogenesis, whereby the mandible and tongue root are extended outward, is the standard treatment to relieve upper airway obstruction in severe PRS. Accurate placement of the distraction device is essential but challenging, especially in infants, and requires the pre-operative fabrication of surgical guides based on CT images. Three-dimensional (3D) printing allows for the accurate recreation of objects from digitized models. We compared surgical efficacy and safety of bilateral mandibular distraction osteogenesis using 3D printed or traditionally fabricated surgery guides for treatment of infants with severe PRS.During the period from 2014 to 2016, 22 patients with severe PRS were treated using either traditional or 3D printed surgery guides. We compared outcome measures of operations, including intraoperative bleeding, operation time, and postoperative complications.The 3D printed surgery guide group demonstrated significantly shorter operation time (P <.05) as well as moderately shorter hospital stay and artificial ventilation time (∼1 day less). Furthermore, despite markedly younger average age of the 3D printed group (1.3 vs 3.5 months), there was no increase in postoperative complications using the 3D printed guides.Three-dimensional printed surgery guides were used successfully for bilateral mandibular traction osteogenesis, and according to several outcome, parameters demonstrated superior efficacy and safety compared to traditional guides. Further research is warranted to extend the applications of 3D printed surgical guides for craniofacial surgery.

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Update on mandibular distraction osteogenesis

Cited by 21 publications

References 29 publications

Mandible and Tongue Development

Mandible and Tongue Development

Cephalometric studies of the mandible, its masticatory muscles and vasculature of growing Göttingen Minipigs—A comparative anatomical study to refine experimental mandibular surgery

Three-dimensional printing of surgical guides for mandibular distraction osteogenesis in infancy

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