title: Multistage bone-charged distraction osteogenesis for aesthetic reconstruction of an extensive bone deficiency in the mandible.
abstract: Alveolar and mandibular bone defects impair occlusion and affect the aesthetics of facial contouring, making it difficult to obtain a satisfactory outcome. Treatment with distraction osteogenesis (DO) is particularly difficult in cases in which the defective region extends to close to the inferior margin of the mandible. To overcome the limits of current DO, we developed a method as follows. In the first stage, a submucosal space necessary for bone grafting was prepared by soft tissue expansion through DO. In the second stage, an iliac corticocancellous bone was transplanted with its cancellous side in close contact with the new bone in the space formed on the labial side into this new space. In the third stage, the grafted bone was distracted. This technique requires time, but each surgery is of minimum invasiveness and does not leave a visible scar; use of this technique may expand the limited indication of current DO and dental implants.
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Tokyo Metropolitan Police Hospital, and Department of Oral and Maxillofacial Surgery, Tokyo Women's Medical University School of Medicine, Tokyo, Japan. yorika2@hotmail.com
authors.forename: Yorikatsu
authors.initials: Y
authors.lastname: Watanabe
authors.forename: Ryo
authors.initials: R
authors.lastname: Sasaki
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Ando
authors.forename: Teruo
authors.initials: T
authors.lastname: Okano
authors.forename: Tanetaka
authors.initials: T
authors.lastname: Akizuki
mesh_terms: D000328:Adult; D001860:Bone Plates; D001861:Bone Regeneration / Q000502:physiology; D016025:Bone Transplantation / Q000379:methods; D018277:Carcinoma, Mucoepidermoid / Q000601:surgery; D002921:Cicatrix / Q000473:pathology / Q000601:surgery; D003286:Contracture / Q000601:surgery; D003758:Dental Implantation, Endosseous; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008334:Mandible / Q000601:surgery*; D008339:Mandibular Neoplasms / Q000601:surgery*; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D009061:Mouth Mucosa / Q000473:pathology; D010012:Osteogenesis / Q000502:physiology; D019857:Osteogenesis, Distraction / Q000295:instrumentation / Q000379:methods*; D010027:Osteotomy / Q000379:methods; D019651:Plastic Surgery Procedures / Q000379:methods*; D015626:Tissue Expansion / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods