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P.092 Evaluation of the efficiency of hyperbaric oxygen therapy on distraction osteogenesis applied in rabbits
Posters the treatment of choice in patients with diagnosis of zygomaticomaxillary-orbital fractures (ZMOF).
P.092 Evaluation of the efficiency of hyperbaric oxygen therapy on distraction osteogenesis applied in rabbits I. Mutlu, Y.S. Aydintug, K. Ortakoglu, M. Sencimen. Gulhane Military Medical Academy, Department of Oral and Maxillofacial Surgery, Ankara, Turkey The most common causes of alveolar bone deficiency includes traumatic extractions, periodontal diseases, tumour resections or developmental deformities. For the treatment of these deficiencies, autogenous bone grafts, guided tissue regeneration, alloplastic and allogenic materials were used, although recently distraction osteogenesis (DO) which provides an increase in the height and width of both bone and soft tissue simultaneously takes place of those reconstrution methods. But the long consolidation period of DO becomes a disadvantage for the patient in accepting the treatment. In this study we divided 24 New Zealand rabbits into two equal groups. We applied DO on the lateral surface of the mandible of the rabbits in both groups. One of the groups were given hyperbaric oxygen (HBO) therapy while the other was used as control group. Each group were divided into subgroups. After 30 and 60 days of consolidation period sacrifications were performed. We compared the amount of bone acquired. In the HBO group there was higher amount of new bone formation, but there was statistically no meaning between the 2 groups. Radiographically, as a result of densitometric analysis it was observed that HBO treatment increased the new forming bone density in the short term. But in the histological examinations, the same result was acquired in the group which had waited for long period. As a result we think that HBO treatment can be utilized to increase the quantity and quality of new bone and to decrease the maturation time which shortens the consolidation period of DO.
P.093 Evaluation of three-dimensional stereolithographic model and cephalometric analysis in mandibular distraction osteogenesis with a multiplanar extraoral device K. Ortakoglu1 , M. Sencimen1 , H.A. Ozyigit1 , S. Karacay2 . 1 Gulhane Military Medical Academy, Dpt. Of Oral and Maxillofacial Surgery, Ankara, Turkey; 2 Gulhane Military Medical Academy, Dpt. Of Orthodontics, Ankara, Turkey Objective: Distraction osteogenesis is an alternative treatment method for the correction of mandibular hypoplasia. In this case report, distraction with a multidirectional extraoral device was performed to gradually lengthen the corpus and ramus of a patient who had a severe hypoplastic mandible. Material and Method: The patient underwent bilateral extraoral ramus and corpus distraction osteogenesis. After 7 days of latency period, distraction was performed 0.5 mm twice a day. Subsequent consolidation period was 14 weeks. Results: The patient’s mandible was elongated successfully. Cephalometric analysis revealed that ANB angle decreased from 13 to 4, overjet of 15 mm decreased to 4 mm, corpus length increased from 45 to 67 mm, and ramus length increased from 39 to 44 mm. Posterior airway space (PAS) also increased due to advancement of the mandible. In stereolithographic model evaluation it was determined that the distances from condylion to gonion and from gonion to pogonion increased.
Distraction 155 Conclusion: Satisfactory results from both esthetic and functional standpoints were obtained by distraction osteogenesis of the ramus and corpus. Keywords: Mandibular distraction; Extraoral multidirectional distractor; Class II malocclusion; Hypoplastic mandible; Posterior airway space; Stereolithographic model P.094 Surgically assisted anterior segment distraction with tooth borne appliance (case report) Z. Ny´ar´ady, G. Her´enyi, Gy. Szab´o, L. Olasz. Department of Dentistry and Oral and Maxillofacial Surgery, University P´ecs, P´ecs, Hungary Introduction and Objectives: Segmental distraction of the palate is an accepted method to segmental Le Fort I procedure or K¨ole’s osteotomy in maxillary hypoplasia. The complication and relapse rate is more favourable than in traditional osteotomies. We present a case, where a modified Hyrax is used, as a tooth anchored appliance, for segmental advancement of the anterior maxilla. This seems to be a viable alternative solution, to traditional distractors. Material and Methods: A 17-year-old male patient with maxillary hypoplasia is presented. His maxillary hypoplasia was second to an early nasal septal resection. The patient received a sagittally inserted Hyrax appliance, following a traditional anterior segmental osteotomy. Distraction was started after a 6-day latency period, with a daily rate of 1 mm/day for 10 days. Results: The anterior maxilla was advanced 10 mm. There were no complications. In the next step, a bimaxillary orthognathic operation is planned. The successful advancement decreases the possible complications with segmental Le Fort I procedure, and also creates a sound bone base for the orthodontic correction of crowded teeth. Thus extractions could be avoided. Conclusion: Surgically assisted anterior segmental maxillary distraction is a viable alternative to distraction. In our case there were no complications, the planned results were achieved. ZN and GH contributed equally to the work. P.095 The use of rigid external distraction for midface hypoplasia L.O. Uyanik, H.A. Karasu, D. Aytac. Department of Oral and Maxillofacial Surgery, Ankara University Faculty of Dentistry, Besevler 06500, Ankara, Turkey Introduction and Objectives: Rigid external distraction is an essential treatment modality for the cases of midface hypoplasia. Several operations are performed for the patients with cleft lip and palate to maintain the function from birth to the adolescence. Maxillary growth of the patients with cleft lip and palate is restricted anteroposteriorly,vertically and transversely. Alveolar defects may also cause maxillary hypoplasia. Rigid external distraction is performed for the patients with severe maxillary hypoplasia instead of conventional orthognathic surgeries due to the relapse potential. The aim of this report is to present the cases of rigid external distraction for the treatment of midface hypoplasia caused due to the restricted growth of the patients with cleft lip and palate or alveolar clefts and treatment of patients with developmental defects. Material and Methods: In this report surgical and orthodontic treatment of seven patients with severe maxillary hypoplasia is presented. Rigid external distraction was performed for the maxillary advancement considering that the conventional Lefort I osteotomy would be insufficient. Activation was made 1 mm per
P.092 Evaluation of the efficiency of hyperbaric oxygen therapy on distraction osteogenesis applied in rabbits I. Mutlu, Y.S. Aydintug, K. Ortakoglu, M. Sencimen. Gulhane Military Medical Academy, Department of Oral and Maxillofacial Surgery, Ankara, Turkey The most common causes of alveolar bone deficiency includes traumatic extractions, periodontal diseases, tumour resections or developmental deformities. For the treatment of these deficiencies, autogenous bone grafts, guided tissue regeneration, alloplastic and allogenic materials were used, although recently distraction osteogenesis (DO) which provides an increase in the height and width of both bone and soft tissue simultaneously takes place of those reconstrution methods. But the long consolidation period of DO becomes a disadvantage for the patient in accepting the treatment. In this study we divided 24 New Zealand rabbits into two equal groups. We applied DO on the lateral surface of the mandible of the rabbits in both groups. One of the groups were given hyperbaric oxygen (HBO) therapy while the other was used as control group. Each group were divided into subgroups. After 30 and 60 days of consolidation period sacrifications were performed. We compared the amount of bone acquired. In the HBO group there was higher amount of new bone formation, but there was statistically no meaning between the 2 groups. Radiographically, as a result of densitometric analysis it was observed that HBO treatment increased the new forming bone density in the short term. But in the histological examinations, the same result was acquired in the group which had waited for long period. As a result we think that HBO treatment can be utilized to increase the quantity and quality of new bone and to decrease the maturation time which shortens the consolidation period of DO.
P.093 Evaluation of three-dimensional stereolithographic model and cephalometric analysis in mandibular distraction osteogenesis with a multiplanar extraoral device K. Ortakoglu1 , M. Sencimen1 , H.A. Ozyigit1 , S. Karacay2 . 1 Gulhane Military Medical Academy, Dpt. Of Oral and Maxillofacial Surgery, Ankara, Turkey; 2 Gulhane Military Medical Academy, Dpt. Of Orthodontics, Ankara, Turkey Objective: Distraction osteogenesis is an alternative treatment method for the correction of mandibular hypoplasia. In this case report, distraction with a multidirectional extraoral device was performed to gradually lengthen the corpus and ramus of a patient who had a severe hypoplastic mandible. Material and Method: The patient underwent bilateral extraoral ramus and corpus distraction osteogenesis. After 7 days of latency period, distraction was performed 0.5 mm twice a day. Subsequent consolidation period was 14 weeks. Results: The patient’s mandible was elongated successfully. Cephalometric analysis revealed that ANB angle decreased from 13 to 4, overjet of 15 mm decreased to 4 mm, corpus length increased from 45 to 67 mm, and ramus length increased from 39 to 44 mm. Posterior airway space (PAS) also increased due to advancement of the mandible. In stereolithographic model evaluation it was determined that the distances from condylion to gonion and from gonion to pogonion increased.
Distraction 155 Conclusion: Satisfactory results from both esthetic and functional standpoints were obtained by distraction osteogenesis of the ramus and corpus. Keywords: Mandibular distraction; Extraoral multidirectional distractor; Class II malocclusion; Hypoplastic mandible; Posterior airway space; Stereolithographic model P.094 Surgically assisted anterior segment distraction with tooth borne appliance (case report) Z. Ny´ar´ady, G. Her´enyi, Gy. Szab´o, L. Olasz. Department of Dentistry and Oral and Maxillofacial Surgery, University P´ecs, P´ecs, Hungary Introduction and Objectives: Segmental distraction of the palate is an accepted method to segmental Le Fort I procedure or K¨ole’s osteotomy in maxillary hypoplasia. The complication and relapse rate is more favourable than in traditional osteotomies. We present a case, where a modified Hyrax is used, as a tooth anchored appliance, for segmental advancement of the anterior maxilla. This seems to be a viable alternative solution, to traditional distractors. Material and Methods: A 17-year-old male patient with maxillary hypoplasia is presented. His maxillary hypoplasia was second to an early nasal septal resection. The patient received a sagittally inserted Hyrax appliance, following a traditional anterior segmental osteotomy. Distraction was started after a 6-day latency period, with a daily rate of 1 mm/day for 10 days. Results: The anterior maxilla was advanced 10 mm. There were no complications. In the next step, a bimaxillary orthognathic operation is planned. The successful advancement decreases the possible complications with segmental Le Fort I procedure, and also creates a sound bone base for the orthodontic correction of crowded teeth. Thus extractions could be avoided. Conclusion: Surgically assisted anterior segmental maxillary distraction is a viable alternative to distraction. In our case there were no complications, the planned results were achieved. ZN and GH contributed equally to the work. P.095 The use of rigid external distraction for midface hypoplasia L.O. Uyanik, H.A. Karasu, D. Aytac. Department of Oral and Maxillofacial Surgery, Ankara University Faculty of Dentistry, Besevler 06500, Ankara, Turkey Introduction and Objectives: Rigid external distraction is an essential treatment modality for the cases of midface hypoplasia. Several operations are performed for the patients with cleft lip and palate to maintain the function from birth to the adolescence. Maxillary growth of the patients with cleft lip and palate is restricted anteroposteriorly,vertically and transversely. Alveolar defects may also cause maxillary hypoplasia. Rigid external distraction is performed for the patients with severe maxillary hypoplasia instead of conventional orthognathic surgeries due to the relapse potential. The aim of this report is to present the cases of rigid external distraction for the treatment of midface hypoplasia caused due to the restricted growth of the patients with cleft lip and palate or alveolar clefts and treatment of patients with developmental defects. Material and Methods: In this report surgical and orthodontic treatment of seven patients with severe maxillary hypoplasia is presented. Rigid external distraction was performed for the maxillary advancement considering that the conventional Lefort I osteotomy would be insufficient. Activation was made 1 mm per