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Contemporary Review
Journal Club
May/Jun 2013

Mandibular Osteotomies and Distraction OsteogenesisEvolution and Current Advances

Journal Club PowerPoint Slide Download
Author Affiliations

Author Affiliations: Department of Otolaryngology–Head and Neck Surgery, New York Eye and Ear Infirmary, New York (Dr Saman); Departments of Otolaryngology–Head and Neck Surgery (Drs Saman and Buchbinder) and Oral and Maxillofacial Surgery (Dr Buchbinder), Beth Israel Medical Center, New York; and State University of New York Downstate Medical Center, Brooklyn (Mr Abramowitz).

JAMA Facial Plast Surg. 2013;15(3):167-173. doi:10.1001/jamafacial.2013.44

Importance Although a number of mandibular and occlusal problems may be addressed by orthodontic treatment alone, dentofacial osteotomies are often needed to achieve desired functional or cosmetic results. With the increased popularity of mandibular distraction osteogenesis in recent years, the role of the facial plastic and reconstructive surgeon is crucial in the multidisciplinary care of patients with such problems.

Objective To review the history and evolution of mandibular osteotomies and distraction osteogenesis and to discuss indications, advantages, disadvantages, and recent advances of these techniques.

Evidence Review MEDLINE and PubMed searches without date limits, confined to publications in English, German, and French languages were used to search for terms mandibular advancement, mandibular osteotomy, orthognathic surgery, mandibular distraction osteogenesis, prognathism, and retrognathism in the respective languages. References not found on the sources noted were found in print form in the New York Medical College Library when needed. Particular techniques, as originally described or relating to mandibular osteotomies and mandibular distraction osteogenesis, were critically reviewed.

Findings The goal of surgical mandibular modification procedures is to correct a variety of craniofacial abnormalities for both functional and aesthetic purposes. Multiple techniques of both mandibular osteotomy and distraction osteogenesis have been shown to be effective. Their effectiveness and utility is primarily determined by the specific craniofacial defect and desired outcome, as well as surgeon preference and patient compliance.

Conclusions While mandibular osteotomy has evolved tremendously, distraction osteogenesis continues to grow as a leading method of surgical correction for a variety of craniofacial defects. Current research shows significant strides in making distraction more effective and efficient to use for both the surgeon and the patient. With the growing popularity of these procedures, the up-to-date knowledge of the facial plastic and reconstructive surgeon in these advances is of utmost importance.