computer guided mandibular distraction osteogenesis: a clinical study
The Objectives of The Investigation:
Distraction Osteogenesis (DO) is an integral part in management of mandibular defects associated with HemiFacial Microsomia (HFM) and post-ankylotic mandibular defects. The current study aimed to assess the effect of Three-Dimensionally Constructed Computer Guided Splints on the cosmetic outcome of DO.
Materials and methods:
This study extends upon previous conventionally planned cases of HFM and Post-ankylotic patients in the Cleft Care Center and Out-Patient Clinic of our department. The study cases were 6 patients whom had computer guided surgery using prefabricated splints and the control cases are records of 6 patients whom were previously operated in our department.
Assessment of effect of computer planning on mandibular advancement (SNB angle) showed Significant (P = 0.005) improvement in (study) (Mean= 89 %, SD = 7%) compared to (control) (Mean= 61%, SD= 8%). Assessment of effect of computer-guided surgery on chin deviation showed significant (P = 0.005) improvement in (study) (Mean= 63 %, SD = 7 %) compared to (control) (Mean= 18.3 %, SD= 16.9 %). Assessment of effect of computer-guided surgery on ramus height showed a non-significant (P = 0.2) improvement in study (Mean = 89 %, SD =10 %) compared to control (Mean = 72 %, SD=19.7 %). Assessment of effect of computer planning on correction of smile deviation showed non-significant (P = 0.8) improvement in (study) (Mean= 47%, SD = 38%) compared to (control) (Mean= 41%, SD= 14%).
Computer planning was very successful in improving the chin orientation both antro-posterior and mesio-distal direction (chin deviation). However, it failed in achieving a significant increase in vertical ramal height and in smile deviation correction. In addition, patients in both groups will benefit from soft tissue augmentation to enhance the lateral facial projection.