Ostedistraction in the craniofacial region

In the specific field of maxillofacial surgery, the use of osseous distraction is always more helpful not only in the rehabilitation of malformation pathologies but also in the clinical situations that require bone deficit correction resulting from traumatic events and postsurgical effects, for example oncologic surgery. The reason for the “versatility” in the distraction protocols is without a doubt linked to the fact that they, today, are valid surgical methods in alternative to or supporting maxillofacial surgery since they are feasible from a very early age and allow a quantity of distraction to be obtained that is often larger than that possible by orthopedic means or conventional surgery. There are multiple indications for osteodistraction and they range from cases of hyper- or hypodevelopment of the maxilla and mandible, both their anteroposterior and transverse components, to complex syndromes such as cleft lip and palate. Even the clinical distraction of the upper and middle thirds of the cranium together, through a coronal craniotomy, has been shown to be a safe surgical procedure and it allows, for example, the successful rehabilitation of adult patients afflicted with hemifacial microsomia or craniosynostosis. With the continuous and constant evolution of the integration of osteodistraction principles in the rehabilitation of the craniofacial region, an ever-more effective interdisciplinary relationship between orthodontics and osteodistraction has been seen with growing interest. Increasingly more often treatment plans are programmed in which the orthodontic and osteodistractive phases are integrated and complete each other, each supporting the other. Scientific and clinical progress achieved in this field in recent years, allows more and more refined therapeutic solutions to be programmed, which permit craniofacial operations such as to repair an ankylotic dental arch or reposition osteo-integrated implants to the most convenient bone sites.