Multiple segmental gradual distraction of facial skeleton: an experimental study

Area of Science:

• Craniofacial surgery
• Regenerative medicine
• Orthodontics

Background:

• Distraction osteogenesis is a surgical technique used to grow bone by gradually separating bone segments.
• Facial deformities often require complex surgical correction, with limited options for three-dimensional manipulation.

Purpose of the Study:

• To evaluate the feasibility of multiple segmental distraction osteogenesis in the adult sheep craniofacial skeleton.
• To assess the potential for controlled, three-dimensional repositioning of facial segments and new bone formation.

Main Methods:

• A Le Fort II osteotomy and circumferential orbital osteotomies were performed on 3 adult sheep.
• Segments were advanced using a distraction apparatus, with periosteum preservation and titanium bone screws for marking.
• Radiographic, clinical, and histological assessments were used to evaluate new bone formation and segment movement.

Main Results:

• The midface was advanced by 30 mm, the left orbit laterally by 20 mm, and the right orbit forward by 20 mm.
• Significant new bone formation was observed in the distracted areas across all assessment methods.
• Concomitant globe movement was noted in both orbits following distraction.

Conclusions:

• Multiple segmental distraction osteogenesis is a viable technique in the adult sheep craniofacial skeleton.
• This method allows for controlled, three-dimensional correction of complex facial deformities.
• The findings suggest potential applications for treating craniofacial anomalies in humans.