Morbidity related to transmandibular distraction osteogenesis for patients with developmental deformities.
BACKGROUND
The aim of this retrospective observational case series study was to determine the morbidity of transmandibular Distraction Osteogenesis (DO) using a bone-borne distraction device to adapt the surgical protocol and improve hardware design.


METHODS
The treatment of 23 consecutive, non-syndromic patients who underwent transverse mandibular DO after a midline symphyseal osteotomy with the TransMandibular Distractor (TMD ) was evaluated. The follow-up period lasted at least 1 year after the end of the contention period. Treatments were analysed according to the morphological and functional Success Criteria (SC) for Craniofacial Distraction Osteogenesis (CFDO) for patients with developmental dentofacial malformations established by the steering group of European Collaboration on Cranial Facial Anomalies (EUROCRAN).


RESULTS
Appropriate distraction was obtained in 22 of the 23 patients. One patient had irreversible dentition damage, consisting of an inadvertent apical section. All other SC for CFDO were fulfilled 100% at 1 year follow-up. Seven patients suffered from short-term local infections during different phases of treatment. Two patients suffered subluxation of a central incisor that healed uneventfully. Local discomfort due to delayed union (in three patients) and trauma to the lower lip (one patient) were also observed.


CONCLUSIONS
The main problems were high local infection rates and damage to an apex that required a root filling, as well as patient discomfort due to delayed union and/or the bulkiness of the TMD device. Based on the results of this morbidity study, modifications are recommended for both the surgical protocol and the TMD device hardware.
Mommaerts
Maurice Y
MY
Division of Maxillo-Facial Surgery, Department of Surgery, General Hospital St. Jan, Bruges, Belgium. maurice.mommaerts@azbrugge.be
Spaey
Yannick J E
YJ
Soares Correia
Pedro E G
PE
Swennen
Gwen R J
GR
D000293:Adolescent; D000328:Adult; D002648:Child; D002680:Chin / Q000601:surgery; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008046:Lip / Q000293:injuries; D008297:Male; D008334:Mandible / Q000601:surgery*; D019767:Maxillofacial Abnormalities / Q000601:surgery*; D019647:Oral Surgical Procedures / Q000009:adverse effects*; D019857:Osteogenesis, Distraction / Q000009:adverse effects*; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000209:etiology; D014084:Tooth Avulsion / Q000209:etiology; D014092:Tooth Root / Q000293:injuries