Using orthodontic elastic traction during the active period of distraction osteogenesis to increase the effective vertical extension of hemifacial microsomia patients: A multi-center randomized clinical trial |
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| Affiliation: | 1. Department of Plastic and Reconstructive Surgery, Xiangya III Hospital of Central South University, 138 tongzipo Road, 410000, Changsha City, People’s Republic of China;2. Department of Plastic and Reconstructive Surgery, Shanghai Ninth People''s Hospital, Shanghai JiaoTong University School of Medicine, China;3. The College of Cedical Instrument, Shanghai University of Medicine & Health Sciences, No.257 Zhouzhu Highway, Pudong District, Shanghai, China;4. Department of Oral and Craniofacial Science, Shanghai Ninth People''s Hospital, Shanghai Jiao Tong University School of Medicine, China;5. Department of Plastic and Reconstructive Surgery, Maternal and Child Health Care Hospital of Hainan Province, Haikou, 570206, China;1. Department of Prosthetic Dentistry, University Hospital Würzburg, Pleicherwall 2, 97070, Würzburg, Germany;2. Department of Oral and Maxillofacial Plastic Surgery, University Hospital Würzburg, Pleicherwall 2, 97070, Würzburg, Germany;3. Institute for Hygiene and Microbiology, University of Würzburg, Josef-Schneider-Straße 2, 97080, Würzburg, Germany;4. Department of Psychology (Biological Psychology, Clinical Psychology and Psychotherapy), University of Würzburg, Marcusstraße 9–11, 97070, Würzburg, Germany;1. Nankai University, Tianjin, 300071, China;2. Tianjin Stomatological Hospital, School of Medicine, Nankai University, Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin 300041, China;1. Nitte Meenakshi Institute of Craniofacial Surgery, Nitte Deemed to be University, India;2. Dept. of Periodontics, Srinivas Inst. of Dental Sciences, RGUHS, India;3. Dept. of Cleft and Craniofacial Orthodontics, Nitte Meenakshi Institute of Craniofacial Surgery, Nitte Deemed to be University, India;4. Dept. of Oral and Maxillofacial Surgery, A.B.Shetty Memorial Inst. of Dental Sciences, Nitte Deemed to be University, India;5. Klinik Professor Sailer, Zurich, Switzerland;1. Bács-Kiskun County Hospital, Teaching Hospital of the University of Szeged, Department of Oral and Maxillofacial Surgery and Otolaryngology, Nyíri út 38, Kecskemét, Hungary;2. Doctoral School of Clinical Medicine, University of Szeged, Kálvária Sugárút 57, Szeged, Hungary;3. Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Faculty of Medicine, University of Szeged, Kálvária Sugárút 57, Szeged, Hungary;4. Multidisciplinary Head and Neck Cancer Center, National Institute of Oncology, Ráth György Utca 7-9, Budapest, Hungary;1. Department of Pediatric Cranio-Maxillo-Facial Surgery, Hôpital Femme Mère Enfant, 59 Boulevard Pinel, 69677, Bron, France;2. Department of Cranio-Maxillo-Facial Surgery, Centre Hospitalo-Universitaire Nord, Avenue Albert Raimond, 42000, Saint-Etienne, France;3. Université Jean Monnet, 6 Rue Basse des Rives, 42100, Saint-Étienne, France;4. Department of Pediatric Neurosurgery, Hôpital Femme Mère Enfant, 59 Boulevard Pinel, 69677, Bron, France;5. Université Claude Bernard Lyon 1, 43 Boulevard Du 11 Novembre 1918, 69100, Villeurbanne, France |
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| Abstract: | In this study, the aim was to assess whether using elastic traction during the active period of distraction osteogenesis could effectively increase the vertical extension.Patients with Pruzansky-Kaban Type II mandibular deformity were recruited and randomly assigned into Elastic traction + Distraction Osteogenesis group or Distraction Osteogenesis group, respectively. During the active period, the experimental group received orthodontic elastic traction 3 days after distraction osteogenesis implantation, while the control group received no treatment. All the participants underwent computed tomography (CT) examination before surgery, at the end of the active period, 6 months and 2 years after distraction osteogenesis tractor implantation. The primary outcome was the effective vertical extension rate of the mandible from the baseline to the end of the active period after operations, and there were 7 secondary outcomes used.70 patients were included. The effective vertical extension rates were 85.021% ± 7.432% (mean ± SD) and 68.811% ± 9.510% (mean ± SD) in the experimental and control groups, respectively (P = 0.001). The average distances between the lower middle incisor point to the sagittal plane at the end of the active period were 2.485 ± 1.411 mm and 3.938 ± 2.293 mm in the experimental and control groups, respectively (P = 0.026). At the end of the active period of distraction osteogenesis, the average values of the mandibular occlusal plane canting were −4.887 ± 3.126 mm and −0.177 ± 4.029 mm in the experimental and control groups, respectively (P = 0.026).Elastic traction-assisted distraction osteogenesis could improve traction efficiency and facial symmetry. |
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| Keywords: | Hemifacial microsomia Elastic traction Distraction osteogenesis |
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