title: Complications of mandibular distraction osteogenesis for acquired deformities: a systematic review of the literature.
abstract: A systematic review on complications in all forms of mandibular distraction osteogenesis (MDO) for acquired deformities was performed. 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 Controlled Trials Register yielded 644 articles published between 1966 and mid October 2013. Three hundred and twenty-one eligible articles were screened in detail. Complications related to MDO in acquired deformities were reported in 105 clinical articles, involving 1332 patients. Treatments included alveolar distraction osteogenesis (ADO), mandibular lengthening, DO in bone grafts, and bi-/trifocal transport disc DO (TDDO) for segmental mandibular defects. A high incidence of complications was seen in MDO for acquired deformities (ADO 44.4%; residual group 43.9%). An index for classifying complications in MDO, based on the impact and further treatment or final results, was used. In the ADO group, soft tissue complications (8.0%), insufficient vector control (7.6%), temporary inferior alveolar nerve (IAN) neurosensory disturbances (6.5%), device-related problems (3.5%), mandible fractures (2.8%), insufficient bone formation (2.5%), and fracture of the transport disc (1.3%) were seen. In the residual group, temporary IAN neurosensory disturbances (13.4%), minor infection (5.3%), DO failure (4.0%), and device-related problems (3.8%) were reported.
authors.affiliation: Department of Oral and Maxillofacial Surgery, VU University Medical Centre and Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The 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, The Netherlands.
authors.forename: S E C M
authors.initials: SE
authors.lastname: van de Vijfeijken
authors.affiliation: Department of Oral and Maxillofacial Surgery, VU University Medical Centre and Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands.
authors.forename: D B
authors.initials: DB
authors.lastname: Tuinzing
authors.affiliation: Department of Oral and Maxillofacial Surgery, Academic Medical Centre/Emma Children Hospital and Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The 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: D016025:Bone Transplantation; D006801:Humans; D008336:Mandibular Diseases / Q000601:surgery*; D019857:Osteogenesis, Distraction; D011183:Postoperative Complications
keywords: PRISMA statement; TMJ ankylosis; alveolar process; complicated; complication; distraction osteogenesis; failure; mandible; mandibular; morbidity; obstructive sleep apnoea; systematic review