Distraction osteogenesis. A new development in craniofacial surgery

By means of distraction osteogenesis (callus distraction) it is possible to reshape bone by creating stress across an iatrogenic fracture line. Subsequent to the successful use of this method in orthopaedic surgery, the development of small intra-oral distractors has opened up the possibilities for its application in maxillo-facial surgery, and the correction of orthodontic and dental problems. Following corticotomy and the fixing of the distractor, it is usually possible to begin adjustment on the fifth post-operative day. Adjustment of the distractor twice a day results in a daily distraction of 1 mm. Both congenital and acquired deformities can be corrected in this way. Class II-1 malocclusion can be corrected by simultaneous bilateral distraction. It is concluded that distraction would seem to have a place in maxillo-facial surgery.     

A new condylar positioning technique in orthognathic surgery. Technical note.

In two-jaw surgery, special importance must be attached to the maintenance of the condylar position, particularly in combination with rigid fixation, not only to enhance the stability of the post-operative result but also to avoid iatrogenic temporomandibular joint complications. The new positioning method reported herein is based on a mini fragmentation plate, which can be easily adapted to the bone surface. Reinforcement of the plate by autopolymerizing acrylate, injected into a silicone tube which is pushed over the plate, prevents any unnoticed deformation of the positioning device during surgery. In clinical use, this positioning method has proved to be more versatile and technically less difficult to perform than previous techniques, without any decrease in reliability.