Craniofacial Distraction Osteogenesis by Alexander M. Cherkashin, technique mastered by the lead author, Mikhail L. Samchukov, MD. Read Craniofacial Distraction Osteogenesis book reviews & author details and Mikhail L. Samchukov, MD, Associate Director of Ilizarov Research, Texas. Jason B. Cope, Mikhail L. Samchukov, Alexander M. Cherkashin Mechanisms of New Bone Formation During Distraction Osteogenesis: A Preliminary Report.

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Maxillary distraction has also been experimentally evaluated by Carls and colleagues as a osteogenrsis treatment for velopharyngeal incompetence. Complications associated with the distraction and consolidation periods include inappropriate distraction vector, pin infections, device loosening, device failure, pin tract formation, soft-tissue entrapment, asymmetrical distraction, premature consolidation, dentigerous cyst formation, coronoid process interference, fibrous pseudoarthrosis, paresthesias and trismus.

Craniofacial Distraction Osteogenesis – Mikhail L. Samchukov – Google Books

Fracture of splintering of the bone near the osteotomy may occur due to overzealous drilling, making craniofaciial holes too close to the margin of the bone or sometimes it may occur due to unwanted force exerted on the already drilled pins while performing retraction for drilling craniofwcial other pins on to the bone [ Figure 8 ]. This may include replacement of the distraction device, reorienting the entire distraction device, adjusting the parameters of distraction, elastic fixation or even surgical manipulation may also be required if the regenerate has mineralised.

Handbook of facial growth. However several deformities often involve the ramus, the corpus, and the angle of the mandible. Rosen V, Thies RS.

As we become more comfortable with mere application of exciting techniques, we will most certainly begin to find more novel uses for it, as well as different iterations of previous uses. An experimental study by Glowacki et al. InRachmiel and colleagues reported on multiple segmental distraction of the facial skeleton in three young adult sheep.


Segmental mandibular regeneration by distraction osteogenesis: Osteotomy must be performed with copious irrigation to prevent heating. In bifocal bone transport, one transport disc is created and moved from the residual host bone segment through the defect towards the residual target bone segment docking site. Multi-directional, buried, mandibular intraoral distraction osteogenesis appliances and techniques.

Unfavourable results with distraction in craniofacial skeleton

There are number of variables which modify the protocol such as less time necessary for optimal hard and soft tissue response in younger patients. Distractor is finally activated for few turns depending upon size of the bone. The Incision to access the bone must be conservative in length, with minimal dissection of the periosteum to ensure good blood supply close to the osteotomy site.

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Depending on the direction of lengthening, devices have been classified as unidirectional, bidirectional, or multidirectional devices. The application of osteodistraction offers novel solutions for surgical-orthodontic management of developmental anomalies of the craniofacial skeleton as bone may be molded into different shapes along with the soft tissue component gradually thereby resulting in less relapse.

De Deyne et al. A trabecular bone explant model of osteocyte-osteoblast co-culture for bone mechanobiology.

Unfavourable results with distraction in craniofacial skeleton

J Bone Joint Surg Br. The fixation clamps, in turn, are joined together by a distraction rod which when activated, effectively pushes the clamps and the attached bone segments apart, generating new bone in its path.

The role of latency in mandibular osteodistraction.

The anchoring pins of the distraction device may also cause focal gradual compression. Walker DA, Nish I. An incomplete osteotomy leads to failure to distract. It is most commonly used for the correction of more severe deformities and syndromes of both the maxilla and the mandible and can also be used in children at ages previously untreatable.


Major trends will include: Vector errors can be greatly minimised in this approach. It has been speculated that an increase in shear forces may provide greater stimulation of osteoblasts and ossification centers. The first report demonstrating the application of Ilizarov’s principles to the craniofacial region appeared in At 2 months after distraction, the initial gap was filled with mineralized osteogeneeis and showed remodeling areas, mainly in dense cortical zones.

Use of Indigenous appliances In a developing and economically restrained country like ours, the choices of treatment are restricted. A craniofaacial of 25 mm distraction is possible.

The distraction device should be secured using the anchoring pins and a test distraction should be performed intraoperatively to make sure that the fixation of the device and the osteotomy is complete. Ortho-surgical management of skeletal malocclusions. Technical and tactical errors leading to axial deviation include incorrect alignment of the distraction rod, insufficient anchorage of the osteogeensis, over correction of the deformity and an incorrect rate of distraction.

Various external and internal devices have been designed for use in cranial distraction in which cranial and midface distraction has been successfully conducted for correcting craniofacial deformities of various degrees like Crouzon’s syndrome, Apert’s syndrome, Pfeiffer’s syndrome and midface abnormalities secondary to craniofacial anomalies.

The resulting vector is one of anterior rotation anterior and inferior.