Indications for the use of distraction osteogenesis in orthognathic surgery in children and adolescents

Objective: to provide evidence for the use of distraction osteogenesis in orthognathic surgery for children and adolescents. Material and methods: the study involved the clinical management of 17 pediatric and adolescent patients (nine men and eight women, aged 11–16) who had been diagnosed with micrognathia and retrognathia of the maxilla. The patients were treated at the Department of Maxillofacial Surgery at the Scientific-Clinical Institute of Dentistry and Maxillofacial Surgery using distraction osteogenesis. A combination of clinical and laboratory analyses, diagnostic models, and advanced radiographic imaging modalities were used for diagnostic evaluation, including lateral cephalometric radiography, orthopantomography, and temporomandibular joint radiography. Results: a comprehensive clinical and radiological assessment was followed by a minimally invasive maxillary osteotomy. The osteotomised segment was then advanced using an external distraction device. This resulted in the correct alignment of the jaw and improved the patients’ facial aesthetics. The patients had maxillary micro- and retrognathia. Long-term follow-up over a two-year period revealed no cases of relapse. Conclusions: techniques of distraction osteogenesis in orthognathic surgery are less traumatic and minimise postoperative inflammatory complications. They also allow for the simultaneous performance of osteotomy and controlled threedimensional repositioning of the maxilla.