Cephalometric evaluation of the craniofacial complex in patients treated with an intraoral distraction osteogenesis device: a preliminary report☆

Abstract 

The purpose of this pilot study was to evaluate cephalometrically the efficacy of an intraoral distraction osteogenesis device in treating patients with unilateral mandibular hypoplasia. Six patients with hemifacial microsomia underwent unilateral mandibular distraction. Posteroanterior and 45° lateral oblique cephalograms were measured, and changes in maxillary width and height, occlusal height, ramus height, mandibular length, and chin position were quantified. Measurements were taken preoperatively and postoperatively at 7 time points (T1-T7) over 2 years. Calculations for statistical significance were done to T6 for all patients and through T7 for 4 patients. The means and variances were calculated for the 6 cephalometric variables for each time point. The mean differences between treatment and control were calculated as well as analysis of variance. Mean differences between specific time periods were measured by pairwise comparison with significance determined at the 0.05 level of confidence. Statistical analysis was used for descriptive purposes only. The cephalometric data suggest that the intraoral distractor is as capable of lengthening hypoplastic mandibles as the initial extroral appliances. The bone lengthening appears stable, with the distracted side of the mandible maintaining a growth rate similar to the normal side. Immediately after distraction, transient improvements were noted in maxillary height, ramal height, and maxillary width. All patients demonstrated an immediate improvement in chin position toward the skeletal midline; however, after T4, menton appeared to be moving away from the midline over time.