Mandibular hypoplasia in children: possibilities of compression-distraction osteogenesis

Hypoplasia – is the medical term for underdevelopment. Hypoplasia of the mandible (micrognathia) is associated with underdevelopment of the ramus or body of the mandible, in some cases both at the same time. The main causes of hypoplasia of the lower jaw in children are congenital and acquired. This pathological condition can be detected at the second stage of screening of pregnant women at 19–21 weeks of pregnancy. This pathology leads to both functional (breathing, chewing, swallowing, speech) and aesthetic disorders. Currently, various methods are known for eliminating underdevelopment of the lower jaw, such as the use of allo- and out-grafts or combined, the use of implants made of metals or polymer materials, compression-distraction osteosynthesis. Currently, in our country, as throughout the world, compression-distraction osteosynthesis (CDO) is actively used to eliminate hypoplasia of the lower jaw. Hypoplasia of the mandibular branch combines not only a shortened height, but also a change in the width of the branch.
The use of modern technical achievements (MSCT, OPTG, TRG, ultrasound, CDA, surgical guidance) allows not only to study in detail the deformation of the mandible, but also to supplement the necessary information for precise planning of surgical treatment and obtaining a predictable result. The main principles of surgical treatment of patients with an underdeveloped branch of the mandible are: 1) preoperative planning (production of a stereolithographic model of the skull, for spatial visualization of skeletal asymmetry, and a surgical template necessary for osteotomy and CDA fixation), 2) ultrasound and X-ray control at the distraction stage to determine the correctness of the vector of growth and dynamics of the formation of the jaw callus.

1. Grichanyuk D. A. Ekhograficheskoe issledovanie kak metod prenatal’noj i postnatal’noj diagnostiki pri porokah razvitiya chelyustno-licevoj oblasti. / D. A. Grichanyuk, I. I. Dubrovskaya, L. M. Lishtvan // Med. panorama. – 2007. – № 2. – S. 63–67.

2. Grichanyuk D. A. Nizhnechelyustnoj distrakcionnyj osteogenez, kak osnovnoj metod lecheniya nizhnechelyustnoj gipoplazii (klinicheskij analiz za 5 let) / D. A. Grichanyuk, G. M. Ruman // «Sovremennaya stomato logiya» № 2 – 2017g.

3. Yаsonov S. A., Rabiev D. T., Lopatin A. V.: Sochetanie artroplastiki i distrakcionnogo udlineniya nizhnej chelyusti pri lechenii detej s ankilozami visochno-nizhnechelyustnogo sustava.//Sovremennye tekhnologii v diagnostike i lechenii № 3, 2010.

4. Bjork A., Skieller V.: Normal and abnormal growth of the mandible % a synthessis of longitudinal cefalometric implant studies over a period of 25 years // Eur J Orthod 5:1, 1983.

5. Molina F., Ortiz Monasterio F: Extended indications for mandibular distraction: unilateral, bilateral and bi-directional. In Ortiz Monasterio F, editor: Craniofacial surgery, vol. 5, Bologna, Italy, 1993.

6. Samchukov M., Cope J., Cherkashin A.: Craniofacial distraction osteogenesis. USA, 2001, p. 634.