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Backward distraction osteogenesis in a patient with severe mandibular micrognathia
Nobuyuki Mitsukawa1, Tadashi Morishita, Atsuomi Saiga
1From the *Department of Plastic, Reconstructive and Aesthetic Surgery, Faculty of Medicine, Chiba University, Chiba; †Department of Orthodontics, and ‡Department of Plastic and Reconstructive Surgery, St. Mary's Hospital, Fukuoka, Japan.
The Journal of Craniofacial Surgery
|September 17, 2013
Summary
Severe mandibular micrognathia can be treated with backward distraction osteogenesis, a technique combining sagittal split ramus osteotomy and ramus distraction. This method offers advantages over conventional treatments for jaw deformities.
Area of Science:
- Maxillofacial surgery
- Orthognathic surgery
- Craniofacial anomalies
Background:
- Maxillary skeletal prognathism often presents with severe mandibular micrognathia, retrognathism, or hypoplasia.
- Conventional treatment involves sagittal split ramus osteotomy (SSRO), which can lead to insufficient advancement, instability, and relapse.
- Mandibular distraction osteogenesis offers an alternative but struggles with achieving ideal occlusion due to limitations in 3-dimensional control.
Observation:
- This report details a case of a 14-year-old girl with severe mandibular micrognathia treated using backward distraction osteogenesis.
- This technique, a combination of SSRO and ramus distraction osteogenesis, involves posterosuperior distraction of proximal bone segments after osteotomy and intermaxillary fixation in centric occlusion.
Findings:
- Backward distraction osteogenesis provides a superior surgical technique, overcoming the limitations of SSRO and conventional mandibular distraction.
- The procedure allows for controlled mandibular advancement and correction of severe micrognathia.
Implications:
- While effective, backward distraction osteogenesis places significant load on the temporomandibular joints, necessitating careful patient selection and management.
- Further evaluation of indications and thorough management protocols are crucial for optimizing outcomes in patients with severe mandibular micrognathia.
