Research article summary (published 29 Sep 2009):

A simple mechanism for measuring and adjusting distraction forces during maxillary advancement.

Full Abstract

PURPOSE: Direct measurement of distraction forces on the craniofacial skeleton has never been reported. The present report describes the development of a method of assessing and adjusting traction forces applied through maxillary distraction osteogenesis. MATERIALS AND METHODS: A simple mechanism to measure and adjust tension force during maxillary distraction osteogenesis was developed and connected bilaterally to the traction screws of a rigid external distraction device. Measurements were carried out before and after activation using a Shimpo (Nidec-Shimpo America Corporation, Itasca, IL) force gauge in 4 patients (2 with unilateral cleft lip and/or palate, 1 with bilateral cleft lip and palate, and 1 with noncleft) during the distraction process. Activation was performed twice a day at a rate of 1 mm/day. RESULTS: The average maximum force applied throughout the distraction period was 42.5 N (range 16.4 to 65.3 N), with increments, after activation, averaging 10.5 N (range 7.9 to 15.7 N). In patients with unilateral cleft lip and/or palate, distraction forces on the larger segment were 65.1% higher than on the lesser segment. A differential pattern of forces was also observed in the patients with asymmetric noncleft. However, the differential forces between lateral segments were not observed in the patient with bilateral cleft lip and palate. During the activation period, distraction forces progressively increased, whereas the amount of maxillary movement decreased. Pain and discomfort were reported with high forces. CONCLUSIONS: Through this mechanism, direct measurement and adjustment of distraction forces during maxillary advancement was possible. The unbalanced pattern of forces observed in patients with cleft suggests the necessity of individual adjustments for controlling pain and clinical symptoms. Accordingly, assessment of distraction forces during maxillary distraction osteogenesis is extremely helpful in understanding the biomechanics of the distraction process.

Author information

Author/s: Suzuki, Eduardo Yugo (EY); Suzuki, Boonsiva (B);

Affiliation: Lecturer, Department of Orthodontics, Faculty of Dentistry, Chiangmai University, Chiangmai, Thailand.

Journal and publication information

Publication Type: Journal Article; Research Support, Non-U.S. Gov't

Journal: Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons (J Oral Maxillofac Surg), published in United States. (Language: eng)

Reference: 2009-Oct; vol 67 (issue 10) : pp 2245-53

Dates: Created 2009/09/18; Completed 2009/10/29;

PMID: 19761920, status: MEDLINE (last retrieval date: 10/29/2009, IMS Date: )

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adolescent Biomechanics Cephalometry - methods Cleft Lip - surgery Cleft Palate - surgery Equipment Design External Fixators Humans

Maxilla - physiopathology; surgery Osteogenesis, Distraction - instrumentation; methods Osteotomy, Le Fort - methods Pain - etiology Splints Stress, Mechanical Traction - instrumentation Young Adult

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