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      Distracción osteogénica maxilar transversa con aparato Hyrax intraoral dentosoportado: Presentación de un caso clínico Translated title: Transverse maxillary osteogenic distraction with a tooth-supported intraoral Hyrax appliance: case report

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          Abstract

          Resumen La corrección de las discrepancias dentofaciales puede llevarse a cabo mediante diversos tratamientos como son la ortodoncia convencional compensatoria, la cirugía ortognática y recientemente la distracción osteogénica. Una de las discrepancias dentofaciales que causan controversia para su tratamiento, por la decisión de realizar o no extracciones de órganos dentarios, es la deficiencia maxilomandibular transversa. Estudios realizados en 1991 por Proffit y Little han demostrado que existe un alto índice de recidiva en tratamientos ortodónticos compensatorios, lo que provoca inestabilidad oclusal en el postoperatorio, incrementando así el índice de recidiva. Se presenta el caso clínico de un paciente femenino de 19 años con un diagnóstico de deficiencia maxilar transversa y clase II esqueletal, tratado mediante distracción osteogénica con un aparato Hyrax intraoral dentosoportado, con el fin de mejorar la armonía de la arcada superior, evitando la extracción de órganos dentarios y mejorando la estabilidad oclusal para ser sometida a cirugía ortognática.

          Translated abstract

          Abstract Treatment of dentofacial deformities could be done by conventional orthodontics, orthognatic surgery and recently by osteogenetic distraction. The treatment of transversal maxillary or mandibular deficiency is the most controversial among the dentofacial deformities because of the decision to extract or not healthy teeth. The studies carried out by Proffit and Little in 1991 had shown an increased rate of failure in orthodontic compensatory treatments due to occlusal instability. A case of a 19-year-old patient with transverse maxillary deficiency and Class II profile is presented. The treatment was carried out by means of osteoge-nic distraction with an intraoral tooth-supported Hyrax appliance, with the purpose of increasing the maxillary width, avoiding teeth extraction and improving occlusal stability for orthognatic surgery.

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          Most cited references23

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          The tension-stress effect on the genesis and growth of tissues: Part II. The influence of the rate and frequency of distraction.

          To assess the influence of both the rate and the frequency of distraction on osteogenesis during limb elongation, a canine tibia was used with various combinations of distraction rates (0.5 mm, 1.0 mm, or 2.0 mm per day) and distraction frequencies (one step per day, four steps per day, 60 steps per day). The distractions were performed after both open osteotomy and closed osteoclasis. Histomorphic and biochemical studies were conducted on the elongated osseous tissue, fascia, skeletal muscle, smooth muscle, blood vessels, nerves, and skin. It was determined that distraction at a rate of 0.5 mm per day often led to premature consolidation of the lengthening bone, while a distraction rate of 2.0 mm per day often resulted in undesirable changes within elongating tissues. A distraction rate of 1.0 mm per day led to the best results. It was also observed that the greater the distraction frequency, the better the outcome. With optimum preservation of periosseous tissues, bone marrow, and blood supply at the time of osteotomy, stability of external fixation, and 1.0 mm per day of distraction in four steps, osteogenesis within the distraction gap of an elongating bone takes place by the formation of a physislike structure, in which new bone forms in parallel columns extending in both directions from a central growth zone. The growth plate that forms under the influence of tension-stress has features of both physeal and intramembranous ossification, yet is neither; instead, the distraction regenerated bone is unique, providing numerous applications in clinical traumatology, orthopedics, and other medical disciplines.
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            The tension-stress effect on the genesis and growth of tissues. Part I. The influence of stability of fixation and soft-tissue preservation

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              Transpalatal distraction as a method of maxillary expansion.

              Conventional devices used for surgically assisted rapid palatal expansion are tooth-borne. Dental fixation entails a number of possible drawbacks such as loss of anchorage, skeletal relapse during and after the expansion period, cortical fenestration and buccal root resorption. A bone-borne titanium device with interchangeable expansion modules, used with a callous distraction policy, is presented.
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                Author and article information

                Journal
                rom
                Revista odontológica mexicana
                Rev. Odont. Mex
                Universidad Nacional Autónoma de México, Facultad de Odontología (México, DF, Mexico )
                1870-199X
                2009
                : 13
                : 3
                : 152-157
                Affiliations
                [1] orgnameISSSTE orgdiv1Hospital General Veracruz
                [2] orgnameISSSTE orgdiv1Hospital Regional “1° de Octubre”
                [3] orgnameISSSTE orgdiv1Hospital Regional “1° de Octubre”
                Article
                S1870-199X2009000300152 S1870-199X(09)01300300152
                10.22201/fo.1870199xp.2009.13.3.15580
                af2419ee-04cc-466f-b79f-551fead3ef04

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 24, Pages: 6
                Product

                SciELO Mexico

                Categories
                Casos clínicos

                distracción osteogénica,Hyrax,Dentofacial deformity,Discrepancia dentofacial,osteogenic distraction

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