title: Evaluation of distracted mandibular bone using computed tomography scan and ultrasonography: technical note.
abstract: OBJECTIVE
  Distraction osteogenesis is considered an important reconstruction armamentarium in the management of mandibular deformities and deficiency disorders. The duration of the consolidation period is still a debatable issue among the clinicians. Evaluation of the newly formed bone is the cornerstone for terminating the consolidation period safely. The aim of this study is to find a more conservative protocol for the evaluation of callus distraction by monitoring bone healing using two different examination tools: ultrasonography and dental CT.
  
  
  METHODS
  Four adult patients (three women and one man) underwent mandibular distraction (using two intraoral and two extraoral devices). The latency period was 5-7 days and the distraction was at a rate of 2 mm per day, with 12-14 weeks of consolidation. All patients were evaluated during activation, 3 months, 6 months and 1 year post-distraction. Evaluation included clinical examination, plain radiographs, CT and ultrasonography examinations.
  
  
  RESULTS
  Ultrasonographic examination of the healing callus revealed four different phases of maturation. These phases were similar to the degree of tissue calcification as measured by CT. Tissue density across the distraction wound at the time of distractor removal (12-14 weeks) was equal to or less than one-third of normal bone density.
  
  
  CONCLUSIONS
  Clinical monitoring of mandibular distraction wounds can be successfully achieved through frequent use of ultrasonographic examinations. Standardization of ultrasonography based on CT findings will expand the reliability of ultrasound in monitoring callus maturation. An algorithm for evaluation of distraction wound healing is suggested.
authors.affiliation: Oral and Maxillofacial Surgery Department, Dental School, Ain Shams University, Cairo, Egypt.
authors.forename: H
authors.initials: H
authors.lastname: Selim
authors.forename: N
authors.initials: N
authors.lastname: Elbargothy
authors.forename: Y
authors.initials: Y
authors.lastname: Nabil
authors.forename: I
authors.initials: I
authors.lastname: El-Hakim
mesh_terms: D000328:Adult; D000465:Algorithms; D015519:Bone Density; D002146:Bony Callus / Q000000981:diagnostic imaging*; D002113:Calcification, Physiologic; D005260:Female; D006801:Humans; D008297:Male; D008334:Mandible / Q000000981:diagnostic imaging*; D019186:Mandibular Advancement / Q000379:methods; D019857:Osteogenesis, Distraction; D011859:Radiography; D014463:Ultrasonography; D014945:Wound Healing / Q000502:physiology; D055815:Young Adult