Skip to main content

Treatment of Mandibular Deformities Related to TMD by Vertical Ramus Distraction Osteogenesis

  • Chapter
Contemporary Management of Temporomandibular Disorders

Abstract

To re-establish the dental occlusion, mandibular position and facial appearance, different orthognathic surgical options may be considered. These options include mandibular or bimaxillary surgery or alloplastic joint reconstruction, possibly combined with maxillary surgery. In cases with moderate deformity and minor malocclusion, an acceptable result can be achieved with orthodontic compensatory treatment combined with chin augmentation. Finally, vertical distraction osteogenesis (DO) with or without maxillary surgery may be considered and will be the focus of this chapter.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Dibbets J, Müller B, Krop F, van der Weele L. Deformed condyles and craniofacial growth: findings of the Groningen longitudinal temporomandibular disorder study. Semin Orthod. 2013;19(2):71–80.

    Article  Google Scholar 

  2. Schellhas KP, Piper MA, Omlie MR. Facial skeleton remodeling due to temporomandibular joint degeneration: an imaging study of 100 patients. AJNR Am J Neuroradiol. 1990;11(3):541–51.

    CAS  PubMed  PubMed Central  Google Scholar 

  3. Chen S, Lei J, Fu KY, Wang X, Yi B. Cephalometric analysis of the facial skeletal morphology of female patients exhibiting skeletal class II deformity with and without temporomandibular joint osteoarthrosis. PLoS One. 2015;10(10):e0139743.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  4. Milam SB. Pathogenesis of degenerative temporomandibular joint arthritides. Odontology. 2005;93(1):7–15.

    Article  CAS  PubMed  Google Scholar 

  5. Witulski S, Vogl TJ, Rehart S, Ottl P. Evaluation of the TMJ by means of clinical TMD examination and MRI diagnostics in patients with rheumatoid arthritis. Biomed Res Int. 2014;2014:328560.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Kuseler A, Pedersen TK, Gelineck J, Herlin T. A 2 year followup study of enhanced magnetic resonance imaging and clinical examination of the temporomandibular joint in children with juvenile idiopathic arthritis. J Rheumatol. 2005;32(1):162–9.

    PubMed  Google Scholar 

  7. Pirttiniemi P, Peltomaki T, Muller L, Luder HU. Abnormal mandibular growth and the condylar cartilage. Eur J Orthod. 2009;31(1):1–11.

    Article  PubMed  Google Scholar 

  8. Peltomäki T, Kreiborg S, Pedersen TK, Ogaard B. Craniofacial growth and dento-alveolar development in juvenile idiopathic arthritis patients. Semin Orthod. 2015;21(2):84–93.

    Article  Google Scholar 

  9. Shen G, Darendeliler MA. The adaptive remodeling of condylar cartilage—a transition from chondrogenesis to osteogenesis. J Dent Res. 2005;84(8):691–9.

    Article  CAS  PubMed  Google Scholar 

  10. Kerstens HC, Tuinzing DB, Golding RP, van der Kwast WA. Condylar atrophy and osteoarthrosis after bimaxillary surgery. Oral Surg Oral Med Oral Pathol. 1990;69(3):274–80.

    Article  CAS  PubMed  Google Scholar 

  11. Luder HU. Age changes in the articular tissue of human mandibular condyles from adolescence to old age: a semiquantitative light microscopic study. Anat Rec. 1998;251(4):439–47.

    Article  CAS  PubMed  Google Scholar 

  12. Schiffman EL, Ahmad M, Hollender L, Kartha K, Ohrbach R, Truelove EL, et al. Longitudinal stability of common TMJ structural disorders. J Dent Res. 2017;96(3):270–6.

    Article  CAS  PubMed  Google Scholar 

  13. Hoppenreijs TJ, Stoelinga PJ, Grace KL, Robben CM. Long-term evaluation of patients with progressive condylar resorption following orthognathic surgery. Int J Oral Maxillofac Surg. 1999;28(6):411–8.

    Article  CAS  PubMed  Google Scholar 

  14. Fjeld MG, Arvidsson LZ, Stabrun AE, Birkeland K, Larheim TA, Ogaard B. Average craniofacial development from 6 to 35 years of age in a mixed group of patients with juvenile idiopathic arthritis. Acta Odontol Scand. 2009;67(3):153–60.

    Article  PubMed  Google Scholar 

  15. Twilt M, Schulten AJ, Prahl-Andersen B, van Suijlekom-Smit LW. Long-term follow-up of craniofacial alterations in juvenile idiopathic arthritis. Angle Orthod. 2009;79(6):1057–62.

    Article  PubMed  Google Scholar 

  16. Schiffman E, Ohrbach R, Truelove E, Look J, Anderson G, Goulet JP, et al. Diagnostic recommendations of the International RDC/TMD Consortium Network* and Orofacial Pain Special Interest Groupdagger. J Oral Facial Pain Headache. 2014;28(1):6–27.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Stoustrup P, Twilt M, Spiegel L, Kristensen KD, Koos B, Pedersen TK, et al. Clinical orofacial examination in juvenile idiopathic arthritis: international consensus-based recommendations for monitoring patients in clinical practice and research studies. J Rheumatol. 2017;44(3):326–33.

    Article  PubMed  Google Scholar 

  18. Kristensen KD, Schmidt B, Stoustrup P, Pedersen TK. Idiopathic condylar resorptions: 3-dimensional condylar bony deformation, sign and symptoms. Am J Orthod Dentofac Orthop. 2017;152(2):214–23.

    Article  Google Scholar 

  19. Larheim TA, Abrahamsson AK, Kristensen M, Arvidsson LZ. Temporomandibular joint diagnostics using CBCT. Dentomaxillofac Radiol. 2015;44(1):20140235.

    Article  CAS  PubMed  Google Scholar 

  20. Larheim TA. Role of magnetic resonance imaging in the clinical diagnosis of the temporomandibular joint. Cells Tissues Organs. 2005;180(1):6–21.

    Article  PubMed  Google Scholar 

  21. Huang YL, Pogrel MA, Kaban LB. Diagnosis and management of condylar resorption. J Oral Maxillofac Surg. 1997;55(2):114–9; discussion 119–20.

    Article  CAS  PubMed  Google Scholar 

  22. McCarthy JG, Schreiber J, Karp N, Thorne CH, Grayson BH. Lengthening the human mandible by gradual distraction. Plast Reconstr Surg. 1992;89(1):1–8.

    Article  CAS  PubMed  Google Scholar 

  23. Mericle PM, Wilson VK, Moore TL, Hanna VE, Osborn TG, Rotskoff KS, et al. Effects of polyarticular and pauciarticular onset juvenile rheumatoid arthritis on facial and mandibular growth. J Rheumatol. 1996;23(1):159–65.

    CAS  PubMed  Google Scholar 

  24. Karaharju-Suvanto T, Peltonen J, Kahri A, Karaharju EO. Distraction osteogenesis of the mandible. An experimental study on sheep. Int J Oral Maxillofac Surg. 1992;21(2):118–21.

    Article  CAS  PubMed  Google Scholar 

  25. Costantino PD, Friedman CD. Distraction osteogenesis. Applications for mandibular regrowth. Otolaryngol Clin North Am. 1991;24(6):1433.

    Article  CAS  PubMed  Google Scholar 

  26. Diner PA, Tomat C, Soupre V, Martinez H, Vazquez MP. Intraoral mandibular distraction: indications, technique and long-term results. Ann Acad Med Singapore. 1999;28(5):634–41.

    CAS  PubMed  Google Scholar 

  27. Huang CS, Ko WC, Lin WY, Liou EJ, Hong KF, Chen YR. Mandibular lengthening by distraction osteogenesis in children—a one-year follow-up study. Cleft Palate Craniofac J. 1999;36(3):269–74.

    Article  CAS  PubMed  Google Scholar 

  28. Mehrotra D, Vishwakarma K, Chellapa AL, Mahajan N. Pre-arthroplasty simultaneous maxillomandibular distraction osteogenesis for the correction of post-ankylotic dentofacial deformities. Int J Oral Maxillofac Surg. 2016;45(7):820–7.

    Article  CAS  PubMed  Google Scholar 

  29. Gupta GM, Gupta P, Sharma A, Patel N, Singh A. Evaluation of functional and esthetic outcome after correction of mandibular hypoplasia secondary to temporomandibular ankylosis treated by distraction osteogenesis. J Maxillofac Oral Surg. 2014;13(2):152–8.

    Article  PubMed  Google Scholar 

  30. Rachmiel A, Manor R, Peled M, Laufer D. Intraoral distraction osteogenesis of the mandible in hemifacial microsomia. J Oral Maxillofac Surg. 2001;59(7):728–33.

    Article  CAS  PubMed  Google Scholar 

  31. Guyette TW, Polley JW, Figueroa A, Botts J, Smith BE. Changes in speech following unilateral mandibular distraction osteogenesis in patients with hemifacial microsomia. Cleft Palate Craniofac J. 2001;38(2):179–84.

    Article  CAS  PubMed  Google Scholar 

  32. Klein C, Howaldt HP. Mandibular micrognathism as a sequela of early childhood capitulum fractures and their treatment using distraction osteogenesis. Fortschr Kiefer Gesichtschir. 1996;41:147–51.

    CAS  PubMed  Google Scholar 

  33. Lee Y, Kim K. Treatment of bilateral condylar fractures of the mandible with distraction osteogenesis device. Plast Reconstr Surg. 2009;123(1):28e–9e.

    Article  PubMed  Google Scholar 

  34. Norholt SE, Pedersen TK, Herlin T. Functional changes following distraction osteogenesis treatment of asymmetric mandibular growth deviation in unilateral juvenile idiopathic arthritis: a prospective study with long-term follow-up. Int J Oral Maxillofac Surg. 2013;42(3):329–36.

    Article  CAS  PubMed  Google Scholar 

  35. Mackool RL, Shetye P, Grayson B, McCarthy JG. Distraction osteogenesis in a patient with juvenile arthritis. J Craniofac Surg. 2006;17(2):387–90.

    Article  PubMed  Google Scholar 

  36. Singer SL, Southall PJ, Rosenberg I, Gillett D, Walters M. Mandibular distraction osteogenesis and maxillary osteotomy in a class II division 1 patient with chronic juvenile arthritis. Angle Orthod. 2006;76(2):341–8.

    PubMed  Google Scholar 

  37. Scroggins SE, Baran AS, Angel MF, Caloss R. Distraction osteogenesis as a treatment for retrognathia and obstructive sleep apnea resulting from temporomandibular joint septic arthritis: a case report. J Oral Maxillofac Surg. 2012;70(9):e509–15.

    Article  PubMed  Google Scholar 

  38. Schendel SA, Tulasne JF, Linck DW III. Idiopathic condylar resorption and micrognathia: the case for distraction osteogenesis. J Oral Maxillofac Surg. 2007;65(8):1610–6.

    Article  PubMed  Google Scholar 

  39. Meazzini MC, Mazzoleni F, Gabriele C, Bozzetti A. Mandibular distraction osteogenesis in hemifacial microsomia: long-term follow-up. J Craniomaxillofac Surg. 2005;33(6):370–6.

    Article  PubMed  Google Scholar 

  40. Ascenco AS, Balbinot P, Junior IM, D’Oro U, Busato L, da Silva FR. Mandibular distraction in hemifacial microsomia is not a permanent treatment: a long-term evaluation. J Craniofac Surg. 2014;25(2):352–4.

    Article  PubMed  Google Scholar 

  41. Stoustrup P, Kristensen KD, Kuseler A, Gelineck J, Cattaneo PM, Pedersen TK, et al. Reduced mandibular growth in experimental arthritis in the temporomandibular joint treated with intra-articular corticosteroid. Eur J Orthod. 2008;30(2):111–9.

    Article  PubMed  Google Scholar 

  42. Lochbuhler N, Saurenmann RK, Muller L, Kellenberger CJ. Magnetic resonance imaging assessment of temporomandibular joint involvement and mandibular growth following corticosteroid injection in juvenile idiopathic arthritis. J Rheumatol. 2015;42(8):1514–22.

    Article  CAS  PubMed  Google Scholar 

  43. Oye F, Bjornland T, Store G. Mandibular osteotomies in patients with juvenile rheumatoid arthritic disease. Scand J Rheumatol. 2003;32(3):168–73.

    Article  CAS  PubMed  Google Scholar 

  44. Pedersen TK, Norholt SE. Early orthopedic treatment and mandibular growth of children with temporomandibular joint abnormalities. Semin Orthod. 2011;17(3):235–45.

    Article  Google Scholar 

  45. Mobarak KA, Espeland L, Krogstad O, Lyberg T. Mandibular advancement surgery in high-angle and low-angle class II patients: different long-term skeletal responses. Am J Orthod Dentofac Orthop. 2001;119(4):368–81.

    Article  CAS  Google Scholar 

  46. Norholt SE, Jensen J, Schou S, Pedersen TK. Complications after mandibular distraction osteogenesis: a retrospective study of 131 patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011;111(4):420–7.

    Article  PubMed  Google Scholar 

  47. Ow A, Cheung LK. Skeletal stability and complications of bilateral sagittal split osteotomies and mandibular distraction osteogenesis: an evidence-based review. J Oral Maxillofac Surg. 2009;67(11):2344–53.

    Article  PubMed  Google Scholar 

  48. Andersen K, Pedersen TK, Svendsen P, Hauge EM, Schou S, Norholt SE. Effect of unilateral mandibular distraction osteogenesis on mandibular morphology in rabbits with antigen-induced temporomandibular joint arthritis. Int J Oral Maxillofac Surg. 2015;44(8):1052–9.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Thomas Klit Pedersen .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Cite this chapter

Pedersen, T.K., Nørholt, S.E. (2019). Treatment of Mandibular Deformities Related to TMD by Vertical Ramus Distraction Osteogenesis. In: Connelly, S.T., Tartaglia, G.M., Silva, R.G. (eds) Contemporary Management of Temporomandibular Disorders. Springer, Cham. https://doi.org/10.1007/978-3-319-99909-8_14

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-99909-8_14

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-99908-1

  • Online ISBN: 978-3-319-99909-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics