Search

The aim of this prospective clinical study was to evaluate the short-term and long-term skeletal and dental changes after mandibular osteodistraction with tooth-borne appliances in adult orthodontic patients. The sample consisted of 10 non-growing Caucasian patients with a Class II skeletal relationship due to mandibular deficiency, together with Class II dental malocclusion. All patients underwent mandibular distraction osteogenesis (MDO) using the ROD1 tooth-borne device. Lateral cephalograms were evaluated at four time intervals: pretreatment (T1), after mandibular distraction (T2), after orthodontic fixed appliance therapy (T3), and at long-term observation 8-year post-distraction (T4). Statistical analyses compared the skeletal and dental changes in intervals T1-T2, T2-T3, T3-T4, T1-T4, and T2-T4. MDO with the ROD1 tooth-borne device produced significant long-term (T1-T4) increases in the SNB angle (2.3°), total mandibular length (5.9mm), and corpus length (4.5mm). Potential adverse sequelae included significant increases in mandibular plane angle (4.3°), lower anterior dental height (2.8mm), and lower posterior dental height (2.5mm). Significant increases in lower incisor proclination occurred during distraction (7.5°). Distraction osteogenesis with tooth-borne appliances offers a minimally invasive surgical method with stable results for correcting mandibular deficiency in non-growing patients., (Copyright © 2013 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)

Previous studies have shown that therapeutic pulsed ultrasound (pulsed) has superior stimulatory effect on bone fracture healing compared with continuous ultrasound (continuous). Our predictive hypothesis was that pulsed ultrasound can produce better bone formation during mandibular osteodistraction than continuous ultrasound. Thirty-six New Zealand rabbits were divided into 3 groups of 12. Osteodistraction was performed at 3 mm/day for 5 days. Group 1 received pulsed, group 2 received continuous ultrasound, and group 3 was the control group (distraction only). Bone formation was assessed by quantitative bone density (QBD), mechanical testing, and histological examination. In the first 2 wks post-distraction, group 2 showed enhanced bone formation more than group 1 (p < 0.05); however, in the 3rd and 4th wks, group 1 showed more bone formation than group 2 (p < 0.05). Earlier stages of bone healing were enhanced more by continuous, whereas late stages were enhanced more by pulsed, ultrasound.