title: Complications of mandibular distraction osteogenesis for congenital deformities: a systematic review of the literature and proposal of a new classification for complications.
abstract: A systematic review of English and non-English language articles on the complications of mandibular distraction osteogenesis (MDO) for patients with congenital deformities was performed, in accordance with the PRISMA statement. Search terms expressing distraction osteogenesis were used in 'AND' combination with search terms comprising 'mandible' and terms for complication, failure, and morbidity. A search using PubMed (National Library of Medicine, NCBI), EMBASE, and the Cochrane Central Register of Controlled Trials yielded 644 articles published between 1966 and mid October 2013. Clinical articles that reported complications related to MDO were included. Finally 81 articles on MDO in congenital deformities were eligible and were screened in detail. Complications including minor infection (6.0%), device-related problems (7.3%), skeletal open bite (2.4%), hypertrophic scar formation (2.1%), facial nerve palsy (1.8%), neurosensory disturbances of the inferior alveolar nerve (1.9%), and (fibrous) non-union (0.7%) were seen. A new index for more detailed classification of complications in MDO is proposed based on six categories that indicate the impact of the complication and its further treatment or final results. The proposed complication index may be a useful tool to classify complications related to MDO.
authors.affiliation: Department of Oral and Maxillofacial Surgery, VU University Medical Centre and Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, Netherlands. Electronic address: cra.verlinden@vumc.nl.
authors.forename: C R A
authors.initials: CR
authors.lastname: Verlinden
authors.affiliation: Department of Oral and Maxillofacial Surgery, VU University Medical Centre and Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, Netherlands.
authors.forename: S E C M
authors.initials: SE
authors.lastname: van de Vijfeijken
authors.affiliation: Department of Epidemiology and Biostatistics, EMGO+ Institute for Health and Care Research and Medical Library, VU University Medical Centre, Amsterdam, Netherlands.
authors.forename: E P
authors.initials: EP
authors.lastname: Jansma
authors.affiliation: Department of Oral and Maxillofacial Surgery, Academic Medical Centre/Emma Children Hospital and Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, Netherlands.
authors.forename: A G
authors.initials: AG
authors.lastname: Becking
authors.affiliation: Division of Maxillofacial Surgery, Department of Surgery, General Hospital St. Jan Bruges, Bruges, Belgium.
authors.forename: G R J
authors.initials: GR
authors.lastname: Swennen
mesh_terms: D006801:Humans; D008334:Mandible / Q000002:abnormalities*; D008336:Mandibular Diseases / Q000151:congenital* / Q000601:surgery*; D019857:Osteogenesis, Distraction; D011183:Postoperative Complications / Q000145:classification*
keywords: PRISMA statement; complicated; complication; congenital; distraction osteogenesis; failure; lengthening; mandible; mandibular; morbidity; syndromic; systematic review