ISSN:1049-2275    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:1049-2275    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:1049-2275    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:1049-2275    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

The effect of osteodistraction on the temporomandibular joint was evaluated in a canine model. Eleven mongrel dogs were used in the study. An intraoral expansion device was placed after an osteotomy was made at the angle of the mandible via an intraoral approach. The mandibles were expanded either fully to 20 mm or partially to 10 mm. After expansion, nine animals were immediately killed; the remaining two were maintained in fixation for an additional 10 weeks. Cephalometric radiographs and computed tomographic scans obtained preoperatively and before killing were evaluated. No gross temporomandibular joint deformation or bodily movement was noted in the expanded or contralateral, unexpanded side. The temporomandibular joints were harvested en bloc for gross and microscopic evaluation. Flattening of the posterior aspect of the expanded condylar head was noted, with thinning of the condylar cartilage. New bone deposition was noted, which was evident as anterior lipping. Condyles maintained in 10 weeks fixation showed reparative changes. No evidence of avascular necrosis, microfracture, or cystic degeneration was noted. This study indicates that the force of distraction can induce bony changes in the temporomandibular joint and that these effects are minimal and reversible.

ISSN:1049-2275    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Mandibular lengthening by gradual distraction has been gaining popularity. However, the effect of osteodistraction on the temporomandibular joint has been evaluated in patients with craniofacial anomalies who underwent mandibular distraction. Five patients had unilateral expansion and five had bilateral expansion. The mandibles were expanded 1 mm per day until the pogonion was in the midline. Preoper-ative, immediate, 6-month, and 12-month panoramic and cephalometric radiographs were evaluated. In unilaterally expanded mandibles, the ipsilateral condyle increased in size and volume, became more upright, and was oriented in a more normal vertical axis. The contralateral unexpanded condyle did not show deformational changes. In those mandibles that were bilaterally expanded, both condyles increased in size and volume and became more symmetrical and upright. Osteodistraction appears to affect bone in both local and distant sites. The expanded condyles were stimulated to ensure a more nearly normal shape, size, and configuration.

ISSN:1049-2275    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Application of distraction osteogenesis to the human craniofacial skeleton in properly selected cases represents a major advance in the treatment of craniofacial deformities. We report our initial clinical experience with a system of miniature distraction devices that permitted maxillary, orbital, and mandibular distraction in a 4-month-old boy with unilateral craniofacial microsomia and anophthalmia. At 6 months of age, after maxillary repositioning and orbital expansion, a costochondral rib graft was used to construct the missing left mandibular ramus and condyle.

ISSN:1049-2275    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Despite improvements in cleft palate surgery, residual oronasal fistulas remain a frustrating problem for plastic and reconstructive surgeons because of a high incidence of failure when scarred and immobile neighboring palatal mucoperiosteum is used for secondary closure. Therefore, my colleagues and I have found it necessary to introduce additional tissue from regional sites to close persistent oronasal fistulas. Although each technique may have its successes, no one method can be consistently depended on to repair large palatal fistulas. Even with regional flaps, dehiscence from a scarred surgical site is quite frequent. However, these flaps may still provide satisfactory coverage with staged reconstruction because they will frequently close a significant percentage of the overall defects, which then may be reused to close the remaining defect.

ISSN:1049-2275    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:1049-2275    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:1049-2275    

出版商:OVID    

年代:1995

数据来源: OVID