Patients' responses to distraction osteogenesis: a multi-centre study

This investigation aimed to compare and contrast practical difficulties experienced by 54 children from three different centres (Mexico City, New York, Paris) treated with either extra-oral or intra-oral distraction devices. The possible effect of distraction osteogenesis on pain/sleeping difficulty, speech and eating problems and disturbance of recreational activities and alteration in sensation were investigated. It was expected that intra-oral devices would reduce the difficulties associated with the distraction process and their psychological effect on the child. Some benefits resulting from the use of intra-oral devices were identified, these included fewer sleeping problems (P = 0.006) and less disturbance of recreational activities (P = 0.002). However, eating and maintaining oral hygiene were more problematic with intra-oral devices the differences between the intra-oral and extra-oral groups was approaching significance at P = 0.07. A major disadvantage of the extra oral device was scarring. In both groups the alteration of lip sensation was temporary, pain was limited to the time of activation of the distraction device. A high level of patients' cooperation was mandatory for successful completion of the treatment.