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Gewählte Publikation:

Koestenberger, H.
Mandibular Corpus Distraction Osteogenesis: An additional Approach for adult Patients with Retrognathic Mandible
Doktoratsstudium der Medizinischen Wissenschaft; Humanmedizin; [ Dissertation ] Medizinische Universität Graz; 2023. pp. 81 [OPEN ACCESS]


Autor*innen der Med Uni Graz:
Jakse Norbert
Pichelmayer Margit
Wendl Brigitte

Purpose: The objective of the present study was to analyse skeletal stability, relapse rate, rate of inferior alveolar nerve (IAN) injury, and the effect on the subregion oropharynx of the upper airway after mandibular distraction osteogenesis (MDO) using cephalometric and 3-dimensional measurements. Material and Methods: The sample comprised cone-beam computed tomography (CBCT) data from 74 patients (56 women, 18 men), mean age 23.3 years (± 8.4), who underwent MDO between 2010 and 2021. Data were collected from patients records and CBCTs recorded preoperatively (T0), after active distraction phase (T1), 12 months after surgery (T2), and optionally, if available, more than 12 months after surgery (T3). Two-dimensional cephalometry measurements and 3-dimensional superimposing- and 3-dimensional oropharynx volume analyses were performed. Results: The mean cephalometric advancement was for Mandibular Body Length (MBL) 10.31 mm (± 3.44), for Mandibular Unit Length (MUL) 7.91 mm (± 2.53), and for SN-Pog 3.96° (± 3.17). 13.39 months after surgery (T2), MUL decreased by 0.45 mm (± 1.62, p = 0.02), and MBL by 0.12 mm (± 2.01, p = 0.597). 43.17 months after surgery (T3), MUL decreased by 0.59 mm (± 1.64, p = 0.224), and MBL by 0.60 mm (± 1.35, p = 0.079). Positive moderate correlation between the amount of distraction and the amount of skeletal instability were identified for the short-term follow-up T2 (MBL p = 0.242; MUL p = 0.001) but not for the long-term T3. High-angle patients (MPA > 38°) showed a correlation with greater amounts of relapse comparing to normal-to-low angle group (MPA ≤ 38°). No correlation was found between the amount of skeletal relapse compared to gender, the chief complaint for surgery, appointment of removing of the connection element of the distractor, and age. The relapse rate (SN-Pog decrease ≥1°) was 13.4% (n = 10) and for SN-Pog angle reduction ≥2° 6.7% (n = 5) respectively. The pharyngeal airway volume was improved by 38.85% of its origin size. No IAN injury was recorded. Conclusion: MDO is a highly stable method of advancing the mandible and the pharyngeal airway in retrognathic adult patients. MDO should not be considered as an all-in-one-solution. It is an addendum to other surgical options.

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