Surgical Treatment in Craniofacial Malformations: Distraction Osteogenesis
Pp. 132-154 (23)
Cristiano Tonello, Adriano Porto Peixoto, Maurício Mitsuru Yoshida, Michele Madeira Brandão, Melissa Zattoni Antoneli and Nivaldo Alonso
Distraction Osteogenesis (DO), a procedure used for correction of large
hypoplasia of facial segments, is a surgical technique that induces new bone formation
by gradual separation of two bone surfaces osteotomized by a mechanical device called
distractor; the principles of this surgery were initially designed by the Russian
orthopedist Gavriil Ilizarov in 1951. Different pathological conditions, mostly
syndromic, may present craniofacial deformities that may not be functionally and
esthetically corrected by conventional treatment methods. Some examples include the
mandibular hypoplasias (Pierre Robin sequence, Oculoauriculovertebral spectrum
(OAVS), Treacher Collins syndrome, temporomandibular joint ankylosis, hypoplasia
of the midface (common finding in individuals with syndromic craniosynostosis, such
as the Apert, Crouzon, Pfeiffer, Muenke and Saethre-Chotzen syndromes). Even
though DO is the method of excellence for the treatment of large hypoplasias, it should
only be used when a large dentofacial deformity cannot be corrected by conventional
orthognathic surgery, which may be used to refine the results achieved by DO in a
second auxiliary stage.
Congenital anomalies, Distraction osteogenesis, Orthodontics.
Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Brazil.