SEARCH · PubMed Health

Results for “Osteogenesis, Distraction”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,081 records · Page 60Linked to original sources

PubMed2006

Vertical bone augmentation: where are we now?

As the prevalence of implants has increased, so has the challenge to augment the remaining osseous structure to house those implants. The biggest surgical challenge clinically is to augment lost bone vertically. The purpose of this article is to review currently available techniques for achieving greater vertical dimension before implant placement. A literature search was conducted using MEDLINE to find all articles published between 1970 and 2004 regarding vertical bone augmentation. Following the literature search, all articles were reviewed and summarized in this review article of vertical bone augmentation. The results of the research showed that guided-bone regeneration, monocortical onlay grafting, and distraction osteogenesis have the potential to be applied to augment deficient areas vertically. The expectations of dimensional gain and bone quality are unique to each technique, as well as the potential complications. Distraction osteogenesis has had the greatest potential for vertical gain, while guided-bone regeneration and monocortical onlay grafting achieve similar results. The choice of procedure is to be based upon the patient's existing anatomy, degree of vertical deficiency, and willingness to participate in treatment.

Alveolar Ridge Augmentation↗

PubMedDate not supplied

Osteogenic sarcoma arising from bony regenerate following Ilizarov femoral lengthening through fibrous dysplasia.

Sarcomatous degeneration of fibrous dysplasia has been previously documented in rare cases, often in association with prior radiation therapy. This case report describes the occurrence of osteosarcoma arising in the distal femur of a 15-year-old male with previous biopsy-proven fibrous dysplasia, who had undergone limb lengthening through a distal femoral corticotomy using the technique described by Ilizarov. In addition, distraction osteogenesis through an area of fibrous dysplasia in the proximal tibia produced a new area of fibrous dysplasia in the regenerate tissue as shown by histopathologic examination. This case raises two questions: (a) whether the biologic stimulus of distraction osteogenesis through abnormal metaplastic bone increases the risk of malignant neoplasia, and (b) whether distraction osteogenesis through dysplastic bone is contraindicated, since the regenerate tissue does not form normal bone.

Bone Lengthening↗

PubMed2005

Mandibular midline distraction using a simple device.

OBJECTIVE: Mandibular midline distraction osteogenesis represents a new option for creation of intra-arch space in the mandibular arch. The aim of this paper is to introduce a simple device (hyrax expander) and method for mandibular midline distraction. STUDY DESIGN: The sample consisted of 24 patients (mean age: 18.07 years) treated with mandibular midline distraction. Hyrax expanders were used as symphyseal distractors, and distraction procedure was carried out with a rate of 1 mm and rhythm of twice daily. RESULTS: Mandibular midline distraction was completed successfully in all patients and the distraction amount was 7.01 mm. No major complication other than mild mucosal irritation and gingival recession was observed. CONCLUSION: The presented method is a viable option for mandibular midline distraction osteogenesis.

Adolescent↗

PubMed2006

Mandibular midline distraction using a simple device.

Adolescent↗

PubMedDate not supplied

Management of tibial bone defects due to high energy trauma using the locally manufactured external fixator by segmental bone transport.

BACKGROUND: Bone defect in long bones is a problem in orthopaedic which needs proper treatment to restore limb length and function of the limb. There are various treatment modalities available to fill the detect like bone grafting, vascularised bone graft, allograft and bone transport through fixators (Ring or Uniplanner). This study was done to determine the outcome of locally manufactured External Fixator (Naseer and Awais ) in the management of tibial bone defect due to trauma. METHODS: This descriptive study was conducted on 20 patients in orthopedic department in Lady Reading Hospital Peshawar and Ayub Teaching Hospital Abbottabad, from Nov 1997 to Nov 2002. Patients from either gender aged between 20 to 50 years, having tibial bone defect of more than five centimeter due to trauma were included in the study. Follow up was done for two years. Outcome measures were adopted according to the classification of the Association for the Study and Application of the Method of llizarov (ASAMI) based on clinical (functional) and radiological findings (defect filling). RESULTS: Out of 20 patients 14 (70%) were males and 6 (30%) were female patients. Right tibia was involved in 12 patients (60%) and left tibia in 8 patients (40%). Bony defects due to firearm injury were in 14 patients (70%) and road traffic accidents were in 6 patients (30%). Radiological (bony) results were excellent in 12 patients (60%), good in 2 patients (10%), fair in 3 patients (15%) and poor in 3 patients (15%). Clinical (functional) results were excellent in 7 patients (35%), good in 8 patients (40%), fair in 4 patients (20%,) and poor in 1 patients (5%,). Post operative complications after distraction osteogenesis were pin tract infections in 8 patients (40%), Axial deviations in 6 patients (30%), foot equinus in 4 patients (20%) and refracture in 1 patient (5%). CONCLUSION: Uniplanner locally manufactured (NASEER & AWAIS) External Fixator for distraction osteogenesis is cheap, easy to apply and gives excellent and comparable results in tibial bone defects.

Adult↗

PubMed2003

Midface distraction to alleviate upper airway obstruction in achondroplastic dwarfs.

OBJECTIVE: The use of midface distraction in patients with achondroplasia and upper airway obstruction secondary to midface hypoplasia has not been reported. In this report, we review the treatment of two patients with severe midface hypoplasia and obstructive sleep apnea secondary to achondroplasia using midface distraction osteogenesis. DESIGN, SETTING, AND PATIENTS: Two patients with achondroplastic dwarfism and midface hypoplasia with airway obstruction were treated in a tertiary referral center for craniofacial disorders. RESULTS AND CONCLUSIONS: Both patients had their tracheostomies decannulated after midface distraction of 25 mm. Midface distraction osteogenesis is useful to alleviate upper airway obstruction from midface hypoplasia seen in achondroplasia.

Achondroplasia↗

PubMed2005

Bilateral mandibular distraction for patients with compromised airway analyzed by three-dimensional CT.

The purpose of this study was to present the method of mandibular distraction osteogenesis in order to improve airway to respiratory distressed patients due to significant mandibular deficiency, and to present the quantitative volumetric evaluation of mandible and upper airway using three-dimensional-CT (3D-CT) before and after distraction. This study involved 12 patients aged 12 months to seven years with various complaints of Obstructive Sleep Apnea (OSA) such as noisy breathing during sleep, waking episodes, pauses in respiration and daytime somnolence. Some of them were considered tracheostomy candidates. All the patients underwent bilateral mandibular distraction under general anesthesia. 3D-CT of face and neck was performed before and after distraction and a quantitative volumetric evaluation of mandibular volume and airway volume was performed. The results reveal successful mandibular advancement with increase of mandibular volume by an average of 28.24% and increase of upper airway volume with a mean of 71.92%. Moreover, there were improved apnea index and oxygen saturation and elimination of OSA symptoms. In conclusion, the results demonstrate that following distraction osteogenesis of hypoplastic mandible the volume of the mandible and upper airway increases, eliminating symptoms of OSA and preventing tracheostomy.

Child↗

PubMed2003

[Expression of matrix metalloproteinase-3 and tissue inhibitor metalloproteinases-1 in regenerated rabbit bone after mandibular osteodistraction].

OBJECTIVE: To observe the expression patterns of matrix metalloproteinase-3 and its inhibitor, tissue inhibitor metalloproteinases (TIMP)-1, in remodeling phase of mandibular distraction osteogenesis. METHODS: Bilateral mandibular osteotomies were performed in 8 mature rabbits. The mandibles were lengthened 6 mm using a custom-made distractor with a rate of 1 mm/d. All animals were killed in 4 weeks after completion of distraction. The distracted calluses were harvested and processed for histology and immunohistochemistry of MMP-3 and TIMP-1. RESULTS: Elevated expression of both MMP-3 and TIMP-1 was found in the distracted calluses resulting from mandibular lengthening. Positive staining for MMP-3 was seen in the osteoblasts and osteocytes, and TIMP-1 was mainly localized in osteoblasts. CONCLUSION: MMP-3 and TIMP-1 appear to play important roles in the remodeling of new bone created by mandibular distraction osteogenesis.

Animals↗

PubMed2005

[The transformation of fibroblast-like cells originating from different tissue into osteoblasts].

OBJECTIVE: To discuss whether fibroblast-like cells can transform into osteoblasts under specific condition during distraction osteogenesis. METHODS: Fibroblast-like cells were cultured in vitro. BMP-2, TGF-beta(1), BMP-2 and TGF-beta(1) were added into the medium, and the cellular change were observed by histochemistry and immunohistochemistry methods. The distraction was given on the membrane of fibroblast-like cells, and the cellular change were observed under the distraction. RESULTS: fibroblast-like cells from the joint could transform into osteoblasts under the effect of BMP-2 or BMP-2 with TGF-beta(1). Fibroblast-like cells from other regions could not transform into osteoblasts. CONCLUSION: The osteoblasts during distraction osteogenesis are multi-origin.

Animals↗

PubMed2004

Resorbable bone distraction: current status and future directions.

Distraction osteogenesis of the craniofacial skeleton has been one of the most exciting developments of the last decade. Parallel development of new biocompatible and resorbable materials inspired the authors to combine these technologies to create a new class of single-stage resorbable bone distraction devices. The authors present their experience to date in 50 patients whom have undergone distraction osteogenesis using resorbable devices.

Absorbable Implants↗

PubMed2001

Traumatic cranial injury sustained from a fall on the rigid external distraction device.

Distraction osteogenesis has become a popular treatment of congenital maxillocraniofacial anomalies. Many ingenious internal and external devices have been developed and used. The rigid external distraction system based on systems previously used in correction of maxillary retrusion offers postoperative adjustment in two dimensions. Figueroa and Polley reported the use of this device with minimal morbidity in children as young as 5 years of age. They reported no problems with infection, bleeding, pain, loosening of the intraoral splint, dental injury, or wear problems in a series of 14 consecutive cleft patients. Recent modification of the system, rigid external distraction II, has allowed it to be applied to more complex craniofacial deformities that require a LeFort III osteotomy. A review of the neurosurgery and orthopedic literature revealed that halo complications relate primarily to the skull pins. In most cases, these complications can be prevented if the device is carefully applied and monitored. Early recognition and prompt treatment of complications are important. After experience with this system for advancement at the LeFort III level, six patients with various syndromes involving the craniofacial skeleton have undergone LeFort III level distraction osteogenesis with the rigid external distraction device in combination with a planned and stabilized frontosupraorbital advancement. In one of these cases, a 7-year-old child fell on the device after discharge from the hospital and sustained a compound depressed skull fracture that required debridement and repair.

Absorbable Implants↗

PubMed2002

The effect of low intensity pulsed ultrasound on regenerate bone in a less-than-rigid biomechanical environment.

The purpose of this study was to investigate effects of low intensity pulsed ultrasound (LIPU) on distraction osteogenesis in a less-than-rigid biomechanical environment in a rabbit model. A less-rigid mini-lengthener was applied and a mid-tibial osteotomy performed in 20 New Zealand White rabbits. After a 7 day latency period, the tibiae were distracted 0.5 mm every 12 hours for 10 days. Ten of the rabbits received LIPU for 20 min/day (ultrasound group) and 10 received sham LIPU (control group) from day 17 until sacrifice on day 37. Radiographs were taken weekly after distraction and the callus area was measured. After sacrifice, dual-energy X-ray absorptiometry (DEXA), torsional testing to failure, and histomorphometry were performed. On radiographs, all the treatment tibiae displayed persistent radiolucencies; however, only one of the control tibiae displayed a radiolucent interzone. Torsional strength of the treatment group was 54% of the contralateral tibia compared to 139% in the control group (p<0.008). Bone density and callus size were not significantly different between the 2 groups; however, the ultrasound group displayed a tendency towards more cartilage and fibrous tissue formation (p<0.16) and less bone (p<0.16) than controls. In a biomechanically unstable environment, LIPU appears to stimulate more cartilage formation in regenerated callus than in controls. This callus is biomechanically inferior to unstimulated callus at the early stage of healing tested. During distraction osteogenesis a sound biomechanical environment is important to achieving anticipated results.

Animals↗

PubMed1999

New developments in craniofacial surgery research.

The recent explosion in our understanding of developmental biology and genetics has enhanced our understanding of craniofacial biology. While it is not possible to summarize all new developments in craniofacial research, this article will review three areas: fetal models and surgery for craniofacial disorders, the biology of distraction osteogenesis, and the molecular mechanisms of cranial suture fusion. Numerous models of craniofacial disorders have been described, including small, short gestation and large, long gestation. The benefits and shortcomings of each are discussed. In addition, we discuss recent studies investigating the molecular mechanisms of mandibular distraction osteogenesis. Finally, we present a review of recent advances in the understanding of mechanisms of craniosynostosis, with particular emphasis on the biology of programmed cranial suture fusion in rodents.

Animals↗

PubMed1994

Force required for bone segment transport in the treatment of large bone defects using medullary nail fixation.

In distraction osteogenesis, different factors influence quality and quantity of bone formation. These factors are rigidity of fixation, frequency, and velocity of transport; and integrity of periosteum, endosteum, and intramedullary vascularization. Little data are available on forces related to distraction osteogenesis and limb lengthening, and no data on forces related to bone segment transport. This experiment investigates the correlation of the bone regeneration process with transport forces. Bone segment transport over an intramedullary nail provides an excellent model for measurement of external forces during distraction osteogenesis because soft-tissue and muscle resistance is reduced as compared with limb lengthening. In an animal experiment (sheep), tibial shaft defects of 20 mm and 45 mm were treated. External transport forces were measured daily during bilateral wire transport of a bone segment over an intramedullary nail. Forces increased during transport. Overall transport forces for large defects were slightly higher than those for small defects, reaching 350 N by the end of transport. For large defects, transport forces leveled off during bone transport and rose again at the end. Correspondingly, for large defects, stress relaxation within the tissues increased during the third and the sixth week of transport. This plateau may be interpreted as a reduction of internal forces within the repair tissues at the distraction site, implying a spreading of the healing phases during the bone regeneration process or geometrically different shapes of the regenerate.

Animals↗

PubMed2005

Treatment of an ankylosed central incisor by single tooth dento-osseous osteotomy and a simple distraction device.

When teeth are replanted after being avulsed, the repair process sometimes results in ankylosis. In a growing child, the ankylosed tooth fails to move along with the remaining alveolar process during vertical growth, resulting in a tooth that gradually appears more and more impacted and requires several reconstructive procedures to correct. Ankylosed teeth can, however, serve as anchorage for orthodontic correction of a malocclusion and as a point of force application for a dentoalveolar segment during alveolar distraction osteogenesis. This case report describes the treatment of a 13-year-old girl whose maxillary left central incisor had been avulsed and replanted 5 years earlier. The tooth had become ankylosed, and it was used to provide "free anchorage" during distalization of the maxillary dentition. The underdeveloped alveolar process adjacent to the ankylosed tooth was reconstructed by dento-osseous segment distraction osteogenesis, by using the ankylosed tooth as the point of force application.

Adolescent↗

PubMed2002

The effects of irradiation and hyperbaric oxygen on bone formation during rabbit mandibular distraction.

[18F-]fluoride positron-emission tomography (PET) was used to assess bone formation during mandibular distraction osteogenesis. There were three study groups: irradiation, irradiation+hyperbaric oxygen and control. The two experimental groups received a tumoricidal dose of irradiation to the mandible, and one group was also given hyperbaric oxygen (2.5 ATA (atmospheres absolute) for 90 min) 18 times preoperatively. Control animals received neither irradiation nor oxygen. A unilateral osteotomy was made and, after a period of latency, bone distraction was started, continued for 2 weeks, and the distraction generated was then allowed to consolidate for 4 weeks. The first PET study was performed at the end of distraction and the second at the end of consolidation. At the end of distraction, the metabolic activity of bone in the distracted area was significantly higher in the controls than in either experimental group; differences between the experimental groups were not statistically significant. By the end of consolidation, activity in the control group had diminished to the same as in the two experimental groups, in which no significant change had occurred. Radioactivity was still significantly higher at second imaging on the distracted than non-distracted side in the control and irradiation+hyperbaric oxygen groups, but not in the group that was only irradiated. The results indicate that previous irradiation disturbs bone formation during mandibular distraction osteogenesis. Hyperbaric oxygen was not able to prevent the suppression of osteogenesis caused by radiotherapy but it might improve bone formation by prolonging high osteogenic activity.

Animals↗

PubMed2001

Alveolar distraction before implantation: a report of five cases and a review of the literature.

This work describes the author's experience with the treatment of alveolar vertical bone atrophy using the distraction osteogenesis technique. Five patients with localized vertical atrophy of the alveolar ridge (loss of one to four teeth) were treated using two different types of distractor devices. All the patients were operated on under local anesthesia without needing hospitalization. The surgical technique used in one of these cases and the results of all of the cases treated are reported in this study. Distraction osteogenesis may be a valid alternative to guided bone regeneration in selected cases for the treatment of vertical atrophy of the alveolar ridge, with a substantial reduction in implantation time.

Alveolar Ridge Augmentation↗

PubMed1995

[Treatment of femoral and tibial septic pseudarthrosis by internal lengthening. Apropos of 24 cases].

Twenty two patients aged 18 to 47 years were treated for 24 infected bone defects and nonunions (6 femora and 16 tibiae) by radical resection of the necrotic bone and distraction osteogenesis techniques to regenerate the excised bone. Nonunion, infection, limb shortening, deformity, and osteoporosis were all addressed simultaneously. All patients underwent either bifocal or trifocal internal lengthening by bone transport technique of sliding a bone fragment, producing distraction osteogenesis behind it until the defect was bridged. The mean bone defect was 8.2 cm, with a range up to 16 cm. Eradication of the infection was achieved in all cases prior to the removal of the fixator. Problems with union requiring bone graft augmentation were encountered in three patients. One patient, who sustained a refracture, underwent an amputation. The mean time to union was 4.4 months, if the time was taken from the day the intercalary segment came in contact with the targed segment. Deformity and length inequality were corrected successfully in the majority of the patients. The bone result was excellent in 15 cases, good in 7, fair in one, and poor in one. The functional result was excellent in 11 cases, good in 8, fair in 3, and poor in 2. Distraction osteogenesis treatment seems to be superior to any other method used for treatment of infected bone defects and nonunions, especially in terms of eradication of osteomyelitis and quality of bone union. However, the ability to achieve excellent bone result in even the worst infected bone defects and nonunions does not guarantee a favourable functional result, unless the patient has an acceptable neurovascular status.

Adolescent↗