• Maxillofacial Plastic and Reconstructive Surgery
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• v.23 no.3
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• pp.258-262
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• 2001

Distraction osteogenesis(DO) can be performed in the bony defect associated with trauma, anomaly, and various kinds of disease. The gap generated by DO is filled with growing callus : during the period of distraction, the osteogenesis is continued. However, there have been few reports about expression pattern of growth factors in newly formed bone during the consolidation periods. We performed DO in the mandibular defect case and studied the expressed pattern of growth factors. Its pattern was compared to that of the same patient. BMP-2 and -4 were strongly expressed in the DO site. Particularly, BMP-4 was not expressed in the normal mature bone, but expressed in new bone in DO. However, there was no difference in the FGF-7 expression between the sites. Therefore, strong expression of BMP-4 are related to new bone formation in DO and they may not be related to the normal homeostasis in human bone. Though FGF-7 is related to the growth of keratinocyte, it may have minimal role in the DO and normal mature bone.

• Journal of the Korean Orthopaedic Association
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• v.54 no.5
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• pp.457-462
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• 2019

The treatment of a brachymetacarpia using conventional distraction osteogenesis requires holding an external fixator following distraction for stability, which causes prolonged discomfort that adversely affects the patient's daily activities. This paper reports a case of a 20-year-old male of brachymetacarpia treated with distraction osteogenesis combined with a plate reducing the period of an external fixator, allowing rapid return to the daily activities, and presenting good clinical results.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.30 no.3
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• pp.225-231
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• 2008

This study evaluated whether there is a difference between a conventional titanium distraction device and a TiN-coated device in terms of implant osseointegration after horizontal distraction osteogenesis in narrow alveolar bone. Four adult mongrel dogs, each weighing $9{\sim}10kg$, were used in this study. The lower premolars were extracted and horizontal distraction was performed with conventional titanium distraction devices (group 1) or TiN-coated devices (group 2). After an 8-week consolidation period, the implants were installed, and the dogs were sacrificed after another 8 weeks. The osseointegration around the implants was evaluated histomorphologically. There was one failure in experimental group 1 because of fracture of the device. Direct bone contact was achieved and there were no significant differences between the control group and experimental groups 1 and 2 in terms of osseointegration around the implants at 8 weeks. In summary, intraoral distraction osteogenesis is a good option for augmenting severely atrophied alveolar ridges, and the TiN-coated device may be useful because of its advantages, which include surface hardness, corrosion resistance, and reduced bacteria.

• The korean journal of orthodontics
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• v.31 no.5 s.88
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• pp.499-504
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• 2001

Transverse skeletal deficiency is a common clincal problem associated with narrow basal and dentoalveolar bone. The clinical characteristics of transverse deficiency presents with anterior crowding and posterior buccal crossbite. Orthodontic expansion, using lip bumper and functional devices, was recommanded for younger ages. However, expansion of lower anterior area in older Patients is unstable and tends to relapse toward the original dimension. Distraction osteogenesis is a unique form of clincal tissue engineering and biologic process of new bone formation between bone segments that are gradually separately by incremental traction. Distraction osteogenesis was considered that great potential for correcting transverse mandibular deficiencies. In this Paper, a case of treated transverse deficiency patients with distraction osteogenesis using tooth-borne and tooth & bone-borne distractor is presented.

• Archives of Plastic Surgery
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• v.35 no.3
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• pp.349-353
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• 2008

Purpose: There are 3 well-known surgical procedures to treat Pierre Robin sequence: tongue-lip adhesion, distraction osteogenesis of mandible, and tracheostomy. The classical tongue-lip adhesion is an effective way to keep airway. The tongue, however, becomes quite non-mobile and appears dormant until the patient could control upper airway and the adhesion can be maintained for prolonged period. Most of all, this procedure does not provide the correction of the micrognathia. Distraction osteogenesis is a good technique to correct micrognathia and to prevent tracheostomies in patients with Pierre Robin sequence. But airway keeping procedure is needed during the distraction period. The purpose of this study is to determine the usefulness of temporary tongue-lip traction during the initial period of mandibular distraction in Pierre Robin sequence patients with severe airway problems requiring operative procedure. Methods: It was a prospective study of 2 Pierre Robin sequence patients aged between 4 months and 6 months requiring surgical procedure to correct recurrent and severe pulmonary complications. Two patients underwent distraction osteogenesis of mandible. During the operation, deep one tension suture was performed to tract the tongue and lip. When the patient gained control of upper airway at the initial period of distraction and micrognathia was corrected, the traction suture was removed. Results: All patients were followed up. No patients complained severe pulmonary complications and tracheostomy could be avoided. No patients had severe pulmonary complication. The pulmonary condition of patients was good. Conclusion: In severe Pierre Robin sequence case, temporary tongue-lip traction is a good assistant method in distraction osteogenesis because this method can avoid tracheostomy.

• Korean Journal of Cleft Lip And Palate
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• v.10 no.2
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• pp.75-80
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• 2007

For the treatment of cleft palate patients, orthognathic surgery has been used by standard protocol. Predictable results have been achieved with standard techniques in slight to moderate maxillary hypoplasia. However, limited advancement and high relapse rate was reported in severe cases. The purpose of the present study was to review the clinical results of distraction osteogenesis in the patients with cleft lip and palate. Distraction osteogenesis has improved results in these patients by allowing soft tissue relaxation and gradual bone generation. Therefore, greater movement of the craniofacial skeleton is possible in severe cases of maxillary retrusion with lower relapse rates. In conclusion, distraction osteogenesis for the advancement of hypoplastic maxilla of cleft patients has shown successful treatment method.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.6
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• pp.516-525
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• 2004

Mandibular symphyseal distraction osteogenesis is an alternative approach for correcting mandibular transverse deficiencies and dental crowding. The traditional approaches for these are extraction of teeth and arch expansion with traditional orthodontic treatment. Also extractions are usually unavoidable in patients with severe crowding. The purpose of this study is to evaluate the effect of mandibular symphyseal distraction osteogenesis by use of tooth-borne expansion appliance. All of 12 patients had been performed distraction osteogenesis. The surgical procedures were accomplished under local anesthesia and intravenous sedation in an ambulatory surgical setting using a routine distraction protocol. The latency period was 5 days or 7 days after symphyseal osteotomies. The rate & rhyth is a intermittent, 0.75mm or 1.0 mm per day and stabilized for 6, 8 weeks after distraction. The time of orthodontic tooth movement after distraction was variable from 2 weeks to 8 weeks (mean 3 weeks). All patients had been evaluated with study casts, plain periapical films, panorama radiograms before & after surgery. Mandibular symphyseal distraction osteogenesis increased mandibular arch width and corrected dental crowding, with paralleling tooth-borne movement, without proclination of the mandibular incisors.

• The Journal of the Korean dental association
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• v.46 no.9
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• pp.563-573
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• 2008

Purpose : The purpose of this study is to investigate the effects of Simvastain, which is HMG-CoA reductase inhibitor, on proliferation and differentiation of osteoblast. Materials & Methods : Twenty-four cell culture plates containing essential medium were seeded with UMR-106 cell lines, at density of 5 x $10^4$ cells per plate. Each plates were incubated with 5% $CO^2$incubator $37^{\circ}C$. Starting from 2 days after incubation, cell culture medias were replaced with Osteogenesis induction media every 2 days, for 12 days. In some plates, 0.01, 0.1, 1, 10, $100\muM$ of Simvastatin were added with Osteogenesis induction media, and classified as "test group". Those not added with Simvastatin were classified as "control group". Results : 1. When Alrizarin Red staining was observed with naked eye, control group showed normal deep red color, but test group show rapid decrease of red color as Simvastatin concentration increased more than $0.1\muM$. 2, When observed with microscope, compared to control group, amount of osteo matrix stained with Alrizarin Red decreased rapidly in Simvastatin concentration more than $0.1\muM$. 3. In optical density analysis, regarding control group as a basis, mineral deposition decreased rapidly when Simvastatin concentration increased more than $0.1\muM$. 4. In flow cytometry analysis, survival rate of UMR-106 cell showed no changes in both control group and test group. Conclusion : From the above results, we were able to identify that Simvastatin inhibited osteogenesis without effecting survival or cell number of osteoblasts.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.28 no.4
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• pp.264-273
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• 2002

Pulsed electromagnetic field (PEMF) was used first to induce osteogenesis in 1974. The appliance which was consisted of the Helmholtz coil configuration have used to osteogensis. The objective of this study was to determine whether PEMF, a frequency of 100 Hz and magnetic field strength of 38 gauss applied to the calvarial defect in rabbit, could affect the induction of osteogenesis and the healing of the graft bone. This field should not produce excitation of nerve or muscle and heating the tissue. To evaluate the effect of PEMF on osteogenesis, 16 rabbit under the same condition was divided into 8 experimental groups and 8 control groups. 10 mm calvarial bone defects were formed around sagittal suture. The defect of left side was left without graft while the defect of right side was grafted by bone harvested from left side. A pulsed electromagnetic field was applied for 8 hours per day. Each group was sacrificed after 1 week, 2 weeks, 4 weeks, 8 weeks. Microscopic specimens were obtained from the calvarial bone defects and surrounding tissue using Hematoxylin-Eosin staining method. The results were as follows. 1. In the group which pulsed electromagnetic field was applied, new bone formation filled up the defect was observed after 4 and 8 weeks effectively. 2. There are no difference in the healing period for the fusion between the bone and graft bone. According to the result, the PEMF with 38 Gauss, 100 Hz was very effective in the healing of bone defect and new bone formation. So The PEMF will be useful in clinical aspect for oseteogenesis.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.27 no.5
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• pp.415-423
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• 2005

Distraction osteogenesis (DO) is frequently used technique in reconstruction of bony defects resulted from tumor resection, congenital deformity, and trauma in the maxillofacial region. Although the histologic and ultrastructural changes associated with distraction osteogenesis have been extensively described, the exact changing of the surrounding tissues, such as nerve tissues, were still unclear. This study observed the histological changes and the expression of nerve growth factor (NGF) in the inferior alveolar nerve (IAN) after distraction osteogenesis. Unilateral mandibular distraction (0.5 mm twice per day for 10 days) was performed in eight mongrel dogs. Two animals were sacrificed at 7, 14, 28 and 56 days after completion of distraction, respectively. The distracted IAN and contralateral control nerve were harvested and processed for histological and innunohistochemical examinations. The signs of acute nerve injuries, such as demyelination and partial discontinuation of nerver fiber, were observed in the distracted IAN on 7 and 14 days after distraction. The initial remyelination and regeneration of distracted IAN were showed at 14 days after completion of distraction. At 56 days later, the histologic features of distracted IAN was similar to those of the normal control IAN. The expression of NGF was significantly increased in most distracted nerve tissues on 7, 14 and 28 days after distraction. On 56 days after distraction, the expression of NGF returned to the normal level. This study suggested that the acute IAN injury caused by mandibular distraction were mostly recovered during consolidation period. The NGF was seemed to be induced from Schwann cell and damaged nerve tissues, and it may have important roles in the initial healing of damaged nerves.