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Restricting facial bone growth with skeletal fixation: a preliminary study
Thomas E Southard1, Robert G Franciscus, Kirk L Fridrich
1Department of Orthodontics, University of Iowa, Iowa City 52242, USA. tom-southard@uiowa.edu
Summary
Rigid skeletal fixation of facial sutures in pigs effectively inhibited bone growth, offering a potential compliance-free method for managing vertical or anterior maxillary excess. This technique restricted midfacial growth, demonstrating a novel approach to orthodontic treatment.
Area of Science:
- Orthodontics
- Craniofacial Surgery
- Developmental Biology
Background:
- Conventional orthodontic treatment for vertical or anterior maxillary excess requires high patient compliance.
- Growth modification in children can be challenging due to compliance issues.
Purpose of the Study:
- To investigate the use of rigid skeletal fixation to modify facial bone growth.
- To assess a compliance-free method for controlling maxillary excess.
Main Methods:
- Phase I: Three 30-day-old pigs underwent rigid fixation of zygomaticomaxillary, frontonasal, and nasomaxillary sutures with miniplates.
- Sham pigs had surgery without plates; control pigs had no surgery.
- Phase II: Two 50-day-old pigs followed the same protocol.
- 3D coordinate landmark analysis and histologic analysis of suture specimens were performed.
Main Results:
- Rigid plating restricted zygomaticolacrimal suture length, maxillary bone length, nasal bone length, midfacial breadth, and frontal bone length (-4% to -36%).
- No significant differences were observed in maxillary height, palatal lengths, or mandibular length.
- Plating induced infraorbital concavity and altered facial morphology.
Conclusions:
- Rigid fixation of frontonasomaxillary and zygomaticomaxillary sutures inhibits facial bone growth.
- This method may offer a compliance-free approach to restricting excess maxillary growth.
- The pig model demonstrated infraorbital features potentially homologous to those in humans.
