Biomechanical and clinical implications of distraction osteogenesis in craniofacial surgery.
BACKGROUND
Craniofacial distraction osteogenesis is an established surgical procedure to correct bony malformations. Force transduction through the osteotomized bone fragments elicits defined biological responses in the gap tissue, which determines the clinical success of the distraction treatment.


OBJECTIVE
The purpose of this investigation was to evaluate clinically a new distraction protocol based on an analysis of the biological and biomechanical parameters executing direct effects on bone regeneration during distraction.


METHODS
A multistep distraction protocol was used in 39 patients and the clinical outcome was monitored postoperatively.


RESULTS
All the distraction cases were successful with a single exception. Segmental displacements were stable clinically and radiologically.


CONCLUSIONS
In order to improve the clinical success of distraction osteogenesis, individual treatment protocols are recommended.
Meyer
Ulrich
U
Department of Cranio-Maxillofacial Surgery, University of Münster, Germany. ulmeyer@uni-muenster.de
Kleinheinz
Johannes
J
Joos
Ulrich
U
D000293:Adolescent; D000328:Adult; D001696:Biomechanical Phenomena; D001861:Bone Regeneration / Q000502:physiology; D005147:Facial Bones / Q000002:abnormalities / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008313:Malocclusion, Angle Class III / Q000601:surgery; D008334:Mandible / Q000002:abnormalities / Q000601:surgery; D008437:Maxilla / Q000002:abnormalities / Q000601:surgery; D040542:Mechanotransduction, Cellular / Q000502:physiology; D024343:Open Bite / Q000601:surgery; D010006:Osteoblasts / Q000502:physiology; D019857:Osteogenesis, Distraction / Q000379:methods; D013314:Stress, Mechanical; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology