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Okoturo E. Review of the Literature on the Current State of Periosteum-Mediated Craniofacial Bone Regeneration. Craniomaxillofac Trauma Reconstr 2024; 17:253-262. [PMID: 39329075 PMCID: PMC11423379 DOI: 10.1177/19433875231214068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/28/2024] Open
Abstract
Study Design This is an article review on the current state of periosteum-mediated bone regeneration (PMBR). It is a known mandibular reconstruction option in children, and though poorly understood and unpredictable, the concerns of developmental changes to donor and recipient tissues shared by other treatment options are nonexistent. The definitive role of periosteum during bone regeneration remains largely unknown. Objective The objective is to review the literature on the clinical and molecular mechanism evidence of this event. Methods Our search methodology was modeled after the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines. Search strategies were categorized into search 1 for clinical evidence of mandibular regeneration and search 2 for gene expression review for craniofacial regeneration. The quality assessment of each publication was undertaken, and inclusion criteria comprise mandibular continuity defect for search 1 and use of gene expression assay propriety kit for search 2. Results 33 studies were selected for search 1 while four studies with non-human subjects were selected for search 2. Monitoring of PMBR onset was advised at 2 weeks post-operative, and the gene expression results showed an upregulation of genes responsible for angiogenesis, cytokine activities, and immune-inflammatory response in week 1 and skeletal development and signaling pathways in week 2. Conclusions The results suggest that young periosteum has a higher probability of PMBR than adult periosteum, and skeletal morphogenesis regulated by skeletal developmental genes and pathways may characterize the gene expression patterns of PMBR.
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Affiliation(s)
- Eyituoyo Okoturo
- Lead Research - Molecular Oncology Program, Medical Research Centre, Lagos State University College of Medicine (LASUCOM), Lagos, Nigeria
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Okoturo E. Genetic determinants of periosteum-mediated craniofacial bone regeneration: a systematic review. Arch Craniofac Surg 2023; 24:251-259. [PMID: 37584066 PMCID: PMC10766501 DOI: 10.7181/acfs.2023.00381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 07/21/2023] [Accepted: 08/01/2023] [Indexed: 08/17/2023] Open
Abstract
BACKGROUND Periosteum-mediated bone regeneration (PMBR) is a recognized method for mandibular reconstruction. Despite its unpredictable nature and the limited degree to which it is understood, it does not share the concerns of developmental changes to donor and recipient tissues that other treatment options do. The definitive role of the periosteum in bone regeneration in any mammal remains largely unexplored. The purpose of this study was to identify the genetic determinants of PMBR in mammals through a systematic review. METHODS Our search methodology was designed in accordance with the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines. We conducted a quality assessment of each publication, and evaluated the differences in gene expression between days 7 and 15. RESULTS A total of four studies satisfied the inclusion criteria. The subjects and tissues examined in these studies were Wistar rat calvaria in two studies, mini-pigs in one study, and calves and mice in one study. Three out of the four studies achieved the necessary quality score of ≥ 3. Gene expression analysis showed increased activity of genes responsible for angiogenesis, cytokine activities, and immune-inflammatory responses on day 7. Additionally, genes related to skeletal development and signaling pathways were upregulated on day 15. Conclusions: The results suggest that skeletal morphogenesis is regulated by genes associated with skeletal development, and the gene expression patterns of PMBR may be characterized by specific pathways.
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Affiliation(s)
- Eyituoyo Okoturo
- Division of Head & Neck Cancer Oral, Department of Maxillofacial Surgery, Lagos State University Teaching Hospital (LASUTH), Lagos, Nigeria
- Molecular Oncology Program, Medical Research Centre, Lagos State University College of Medicine (LASUCOM), Lagos, Nigeria
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Spontaneous Osteogenesis of a Traumatic Mandibular Defect in the Pediatric Population. J Craniofac Surg 2019; 30:1999-2000. [PMID: 31232988 DOI: 10.1097/scs.0000000000005663] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Spontaneous osteogenesis of traumatic mandibular defects in the pediatric population remains a relatively rare phenomenon with only 2 patients reported in the literature. In the adult population, a low threshold exists for bone graft placement in the presence of small mandibular gaps, with no role for spontaneous osteogenesis in significant mandibular defects. The approach to traumatic mandibular defects in the pediatric population is not clearly described in the literature and the risks and benefits associated with donor site morbidity of bone graft harvest must be tempered by the possibility for potential spontaneous osteogenesis. The present study reports 1 such patient in whom a significant mandibular defect healed by means of rigid fixation of the defect and spontaneous osteogenesis, with no functional or esthetic sequelae at long-term follow-up. A review of the pertinent literature was performed, and the authors' approach is discussed. The authors propose that traumatic mandibular defects of < 3 cm in patients under the age of 10 years should be considered for treatment with rigid internal fixation alone and spontaneous osteogenesis.
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Spontaneous Regeneration of Bone in Segmental Mandibular Defect. J Maxillofac Oral Surg 2018; 18:224-228. [PMID: 30996542 DOI: 10.1007/s12663-018-1153-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 09/25/2018] [Indexed: 10/28/2022] Open
Abstract
Aim To highlight the spontaneous regeneration of mandibular segmental defects in young and pediatric cases and to review the literature of this unusual and rare phenomenon. Methodology Two case reports of a 17-year old male and a 8-month-old infant has been presented who underwent resection of mandible for benign tumors. These two cases have been compared with the existing literature of 61 cases published till date. Inference Spontaneous regeneration of mandible as a viable reconstructive option is not practically feasible. The consistency and predictability of the phenomenon is questionable. Bone grafting should probably be done immediately in all cases, even in young patients if a delay would interfere with quality of life. In infants and small children though, we propose that immediate reconstruction may be avoided to allow some regeneration at the defect site. If it does not occur, secondary reconstruction may then be considered.
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Formation of Condyle-Like Structure after Treatment of Temporomandibular Joint Ankylosis: Literature Review and Long-Term Follow-Up of Two Patients. Case Rep Med 2017; 2017:9060174. [PMID: 29098006 PMCID: PMC5643151 DOI: 10.1155/2017/9060174] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 07/30/2017] [Accepted: 08/23/2017] [Indexed: 11/17/2022] Open
Abstract
Treatment of ankylosis is one of the greatest challenges in temporomandibular joint (TMJ) surgery. To provide a satisfactory mouth opening, as well as normal jaw function, and to prevent reankylosis in the long term are the most important principles in the treatment of TMJ ankylosis. These functions have been attained in both of the presented patients in the long term. It is known that heterotopic bone formation is rare in the maxillofacial area, but rapid bone regeneration which reconstitutes a new condyle is rarer. The purpose of the presented paper is to reveal the existence of an inherent capability of the mandible, rapid bone growth of the ramus mandible, and reformation of a previously nonexisting condyle after resection of the ramus in patients with TMJ ankylosis. In this paper, two unusual cases of unexpected condyle-like structure formation after treatment of ankylosis were presented.
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Bhardwaj B, Sharma S, Chitlangia P, Agarwal P, Bhamboo A, Rastogi K. Mandibular Dentigerous Cyst in a 10-Year-Old Child. Int J Clin Pediatr Dent 2016; 9:281-284. [PMID: 27843264 PMCID: PMC5086020 DOI: 10.5005/jp-journals-10005-1378] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 03/21/2016] [Indexed: 11/23/2022] Open
Abstract
Dentigerous cyst is the most common odontogenic cyst. It is characterized by a unilocular radiolucent lesion that encloses permanent tooth buds or, under certain circumstances, displaced tooth buds. Buccal bony expansion and a missing tooth is the most common clinical feature. Various treatment modalities have been mentioned in the literature for management of dentigerous cysts. This article presents a left mandibular dentigerous cyst in a 10-year-old boy. Marsupialization was the treatment of choice and a denturelike space maintainer was provided. Long-term follow-up revealed good healing of the bony lesion.
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Affiliation(s)
- Bindu Bhardwaj
- Professor, Department of Oral Surgery, Mahatma Gandhi Dental College and Hospital, Jaipur, Rajasthan, India
| | - Sunil Sharma
- Professor and Head, Department of Oral Surgery, Mahatma Gandhi Dental College and Hospital, Jaipur, Rajasthan, India
| | - Punit Chitlangia
- Reader, Department of Oral Surgery, Mahatma Gandhi Dental College and Hospital, Jaipur, Rajasthan, India
| | - Prateek Agarwal
- Senior Lecturer, Department of Oral Surgery, Mahatma Gandhi Dental College and Hospital, Jaipur, Rajasthan, India
| | - Amit Bhamboo
- Senior Lecturer, Department of Oral Surgery, Mahatma Gandhi Dental College and Hospital, Jaipur, Rajasthan, India
| | - Komal Rastogi
- Private Consultant, Department of Oral Surgery, Rajasthan India
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Chatzistefanou I, Kabesi S, Paraskevopoulos K, Koliouskas D, Antoniades K. Ewing's Sarcoma of Mandible: An Impressive Case of Spontaneous Mandible Regeneration. Int J Clin Pediatr Dent 2016; 9:273-277. [PMID: 27843262 PMCID: PMC5086018 DOI: 10.5005/jp-journals-10005-1376] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 02/21/2016] [Indexed: 11/23/2022] Open
Abstract
Ewing's sarcoma (ES) is an uncommon aggressive bone malignancy that mainly affects children and adolescents. Mandible involvement is quite rare and usually represents metastasis from another skeletal site. Combined therapy including wide surgical resection and preoperative and postoperative chemotherapy has been demonstrated as the mainstay of therapeutic approach. As improved therapeutic modalities have significantly increased survival over the last decades, functional and esthetic reconstruction of the postmandibulectomy defect is usually necessary for patient's total rehabilitation. We report a case of ES of the mandible with special consideration to the postresection spontaneous structural and functional regeneration of the mandible. HOW TO CITE THIS ARTICLE Chatzistefanou I, Kabesi S, Paraskevopoulos K, Koliouskas D, Antoniades K. Ewing's Sarcoma of Mandible: An Impressive Case of Spontaneous Mandible Regeneration. Int J Clin Pediatr Dent 2016;9(3):273-277.
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Affiliation(s)
- Ioannis Chatzistefanou
- Resident, Department of Oral and Maxillofacial Surgery, Papanikolaou General Hospital, Aristotle University of Thessaloniki Thessaloniki, Greece
| | - Sotiria Kabesi
- Student, Dental School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Konstantinos Paraskevopoulos
- Resident, Department of Oral and Maxillofacial Surgery, Papanikolaou General Hospital, Aristotle University of Thessaloniki Thessaloniki, Greece
| | - Dimitrios Koliouskas
- Consultant and Chief, Department of Pediatrics, Hippokration General Hospital of Thessaloniki, Thessaloniki, Greece
| | - Konstantinos Antoniades
- Professor, Department of Oral and Maxillofacial Surgery, Papanikolaou General Hospital, Aristotle University of Thessaloniki Thessaloniki, Greece
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Goswami M, Bhushan U, Jangra B. Goldenhar Syndrome: A Case Report with Review. Int J Clin Pediatr Dent 2016; 9:278-280. [PMID: 27843263 PMCID: PMC5086019 DOI: 10.5005/jp-journals-10005-1377] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 02/27/2016] [Indexed: 11/23/2022] Open
Abstract
Goldenhar syndrome is a rare condition which is characterized by a multitude of anomalies involving craniofacial structures, vertebrae, internal organs and usually occurs unilaterally. The etiology of this syndrome is unclear since it varies genetically and is linked to a plethora of reasons. Herein, we report a case of Goldenhar syndrome with hemifacial microsomia and microtia along with systemic involvement which was clinically and radio-graphically assessed. Many classical signs of the syndrome were present in the patient along with few rare ones. The various aspects of this rare disease have been discussed with emphasis on timely diagnosis and multidisciplinary approach to manage it. HOW TO CITE THIS ARTICLE Goswami M, Bhushan U, Jangra B. Goldenhar Syndrome: A Case Report with Review. Int J Clin Pediatr Dent 2016;9(3):278-280.
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Affiliation(s)
- Mridula Goswami
- Professor and Head, Department of Pedodontics and Preventive Dentistry Maulana Azad Institute of Dental Sciences, Delhi, India
| | - Urvashi Bhushan
- Postgraduate Student, Department of Pedodontics and Preventive Dentistry Maulana Azad Institute of Dental Sciences, Delhi, India
| | - Babita Jangra
- Postgraduate Student, Department of Pedodontics and Preventive Dentistry Maulana Azad Institute of Dental Sciences, Delhi, India
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Cardinal L, Dominguez GC, Marodin AL, Rau LH. Unusual Spontaneous Mandibular Regeneration of a Large Defect Followed by Orthodontics, Alveolar Distraction, and Dental Implant Rehabilitation: A 10-Year Follow-Up. J Oral Maxillofac Surg 2015; 74:786-93. [PMID: 26706489 DOI: 10.1016/j.joms.2015.11.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 09/22/2015] [Accepted: 11/11/2015] [Indexed: 10/22/2022]
Abstract
This report describes an atypical case of spontaneous mandibular regeneration of a large size bony defect after resection of an aseptic osteonecrotic area near the symphysis and parasymphyseal area. The patient underwent orthodontic therapy, vertical osteogenic distraction of the alveolar bone, and oral rehabilitation with an implant borne prosthesis. This case study also describes the 10-year follow-up of comprehensive multidisciplinary treatment and successful recovery of a patient's esthetic and functional aspects.
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Affiliation(s)
- Lucas Cardinal
- PhD Student, Department of Orthodontics and Pediatric Dentistry, University of São Paulo, São Paulo, SP, Brazil.
| | - Gladys Cristina Dominguez
- Associate Professor, Department of Orthodontics and Pediatric Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | - Aline Luiza Marodin
- Chief Resident, Department of Maxillofacial Surgery, Joana de Gusmao Children Hospital, Florianópolis, SC, Brazil
| | - Levy Hermes Rau
- Program Director, Department of Maxillofacial Surgery, Joana de Gusmao Children Hospital, Florianópolis, SC, Brazil
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Ahmad O, Omami G. Self-regeneration of the mandible following hemimandibulectomy for ameloblastoma: a case report and review of literature. J Maxillofac Oral Surg 2015; 14:245-50. [PMID: 25861189 DOI: 10.1007/s12663-012-0462-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2012] [Accepted: 11/23/2012] [Indexed: 11/29/2022] Open
Abstract
Resection of the mandible with immediate or delayed graft reconstruction is widely used in the treatment of ameloblastoma involving a large portion of the mandible. The purpose of reconstruction is mainly to restore the esthetic appearance and mandibular function of the patient. Spontaneous regeneration of the mandible after resection is rarely encountered. This article reports a rare case of spontaneous regeneration of the mandible after hemimandibulectomy for ameloblastoma in a 16-year-old male patient. We discuss the theories pertaining to the mechanism and source of the new bone formation in this case and review the English literature.
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Affiliation(s)
- Omaid Ahmad
- Department of Adult Restorative Dentistry, University of Nebraska Medical Center College of Dentistry, Lincoln, NE 68583-0740 USA
| | - Galal Omami
- American Board of Oral and Maxillofacial Radiology, Oral and Maxillofacial Radiology, University of Connecticut School of Dental Medicine, Farmington, CT 06030 USA
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Mani V, Sankar Vinod V, George A, Sivaprasad KK. Eosinophilic granuloma of mandibular condyle: resection and complete regeneration. J Maxillofac Oral Surg 2013; 14:107-10. [PMID: 25729234 DOI: 10.1007/s12663-013-0581-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2013] [Accepted: 08/23/2013] [Indexed: 11/28/2022] Open
Abstract
Eosinophilic granuloma is a rare disease of abnormal proliferation of Langerhan cells affecting the jaws of young individuals. We report a case of complete regeneration of condyle in a 13 year old boy with eosinophilic granuloma condyle, who had undergone condylectomy.
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Affiliation(s)
- Varghese Mani
- Department of Oral and Maxillofacial Surgery, Mar Baselios Dental College, Kothamangalam, Kerala India
| | - V Sankar Vinod
- Department of Oral and Maxillofacial Surgery, Mar Baselios Dental College, Kothamangalam, Kerala India
| | - Arun George
- Department of Oral and Maxillofacial Surgery, Mar Baselios Dental College, Kothamangalam, Kerala India
| | - K K Sivaprasad
- Department of Oral and Maxillofacial Surgery, Mar Baselios Dental College, Kothamangalam, Kerala India
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Spontaneous mandibular regeneration: another option for mandibular reconstruction in children? Br J Oral Maxillofac Surg 2013; 51:e63-6. [DOI: 10.1016/j.bjoms.2012.04.255] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2012] [Accepted: 04/13/2012] [Indexed: 11/18/2022]
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Exfoliation and simultaneous formation of condylar process following chronic osteomyelitis of the mandible. J Craniofac Surg 2013; 23:e319-22. [PMID: 22801167 DOI: 10.1097/scs.0b013e31825433f1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
A 26-year-old physically challenged man with a history of 7 months' infection and pus discharge was referred to the oral and maxillofacial department. He had undergone right mandibular teeth extraction 1 year ago, which was followed by pus discharge from an extraoral submandibular fistula after 2 months. Again, incision and drainage and wide-spectrum antibiotic were prescribed, which subsided the symptoms for a short period but did not cure the condition. So, sequestrectomy, complete debridements, and antibiotic therapy were planned for him. In the operating room, it was revealed that the sequestrum was the condylar process, and in follow-up cone-beam computed tomography scan, the condyle was being regenerated simultaneously. One-year follow-up showed successful treatment of the condition.
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Ogunlewe MO, Akinwande JA, Ladeinde AL, Adeyemo WL. Spontaneous Regeneration of Whole Mandible After Total Mandibulectomy in a Sickle Cell Patient. J Oral Maxillofac Surg 2006; 64:981-4. [PMID: 16713818 DOI: 10.1016/j.joms.2006.02.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2004] [Indexed: 11/29/2022]
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Martinez JT, Turvey TA, Proffitt WR. Osseous remodeling after inferior border osteotomy for chin augmentation: an indication for early surgery. J Oral Maxillofac Surg 1999; 57:1175-80; discussion 1181. [PMID: 10513862 DOI: 10.1016/s0278-2391(99)90479-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE This study investigated the relationship of age at surgery and type of fixation to the pattern and extent of bone remodeling associated with inferior border osteotomy for chin augmentation. PATIENTS AND METHODS Four groups of patients with similar chin advancement were established by age at the time of surgery: younger than 15, 15 to 19, 20 to 24, and older than 39 years. Cephalometric radiographs for immediate preoperative, immediate postoperative, and at least 9 months postoperative times were traced, digitized, and superimposed. RESULTS The pattern of osseous remodeling was similar for all age-groups. This consisted of resorption of the superior-buccal aspect of the distal segment, bone apposition on the buccal surface of the proximal segment, and modest resorption at pogonion (mean change, 1 mm or less). There was no significant difference in stability of the chin advancement between wire and rigid (screw) fixation. There was a marked difference in the symphysis thickness regeneration of the youngest group (92% of the original symphysis thickness) compared with the rest of the groups (< or =66%, P < .001). CONCLUSIONS Minimal remodeling at pogonion occurs in all age-groups with both wire and rigid fixation. Regeneration of symphysis thickness is much more complete in patients younger than 15 years at the time of surgery. This is potentially important for early treatment of severe chin deficiency, because it permits additional advancement of the chin later in life, if necessary.
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Affiliation(s)
- J T Martinez
- Department of Oral and Maxillofacial Surgery, University of North Carolina, Chapel Hill 27599-7450, USA
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