Cephalometric analysis of the consolidation phase following bilateral pediatric mandibular distraction.
OBJECTIVE
The goal of the consolidation phase of mandible distraction is to maintain the improvement in maxillomandibular form and relationship while the generated tissue ossifies. During this period, external deforming forces can act on the healing generated bone. The purpose of this study was to describe the potential cephalometric changes that occur following pediatric bilateral mandibular distraction using external devices.


METHODS
Retrospective lateral superimposition cephalometric analyses.


METHODS
Thirty-five cases of pediatric mandible distraction were reviewed. Seven of these cases were included in the study after exclusion criteria were applied. These cases represented a group with severe congenital dysmorphology and a mean device activation of 26.5 mm.


METHODS
Changes in pogonion position, symphyseal plane rotation, mandible length, and mandible length relative to maxillary length during the 18 to 36 days of activation, the eight weeks of consolidation, and the 1-year period following removal of the distraction device were measured.


RESULTS
All patients demonstrated variable changes in position of the mandible during the consolidation phase. The most common were retrusion of pogonion, a decrease in mandible length, and a clockwise rotation of the symphyseal plane. In some cases the changes that occurred during consolidation were greater than those that occurred on 1-year follow-up.


CONCLUSIONS
The consolidation phase of distraction osteogenesis is a dynamic phase and should not be assumed to be static. Multicenter use of this cephalometric technique would help to identify potential risk factors associated with postactivation changes.
Division of Plastic Surgery, University of Washington, Seattle, Washington, USA.
Richard A
RA
Hopper
Ayse T
AT
Altug
Barry H
BH
Grayson
Ingrid
I
Barillas
Yuki
Y
Sato
Court B
CB
Cutting
Joseph G
JG
McCarthy
D002508:Cephalometry; D002648:Child; D002675:Child, Preschool; D019465:Craniofacial Abnormalities / Q000601:surgery*; D006801:Humans; D008334:Mandible / Q000002:abnormalities / Q000254:growth & development / Q000601:surgery*; D019186:Mandibular Advancement / Q000379:methods*; D008342:Mandibulofacial Dysostosis / Q000601:surgery; D008844:Micrognathism / Q000601:surgery; D019857:Osteogenesis, Distraction / Q000295:instrumentation; D012189:Retrospective Studies; D016896:Treatment Outcome