Management of dentofacial deformities patients through distraction osteogensis

ABSTRACT

Distraction osteogenesis is a technique for reconstruction of skeletal deformities. The process involves gradual, controlled displacement of a surgical fracture resulting in simultaneous formation of new bone and expansion of adjacent soft tissue. The clinical ractice of oral and maxillofacial surgery has always involved management of a wide variety of facial bone deformities. Nowdays unilateral and bilateral mandibular deficiencies of the horizontal and vertical ramus can be corrected in infancy, childhood and in adults using different distraction devices. The osteodistraction technique for mandible advancement or elongation of the ascending ramus is established in maxillofacial surgery especially in orthognatic surgery. Extroral as well as intraoral device for mandible advancement are now available. Patients with severe maxillary deficiency present a difficult challenge for the reconstructive team. Traditional orthogantic surgical approaches for these patients can be limited, resulting in undercorrection and compromised aesthetic results. Andso We present our technique for intra-oral device of mandiblular ditraction osteogensis in hemifacial microsomia and fibro ankylosis patient, and maxillary distraction osteogensis in patient with severe maxillary hypoplasia with the use of an external, adjustable, rigid distraction device. We are now treated distraction patients with a precise and controlled distraction process, obtaining predictable results. This technique has allowed us to treat patients in all age groups. In this report we review our indications for maxillary and mandibular distraction and describe our technique using distraction device.