EFFECT OF MANDIBULAR DISTRACTION ON THE TEMPOROMANDIBULAR-JOINT .2. CLINICAL-STUDY

Mandibular lengthening by gradual distraction has been gaining popular ity. However, the effect of osteodistraction on the temporomandibular joint has been evaluated in patients with craniofacial anomalies who u nderwent mandibular distraction. Five patients had unilateral expansio n and five had bilateral expansion. The mandibles were expanded 1 mm p er day until the pogonion was in the midline. Preoperative, immediate, 6-month, and 12-month panoramic and cephalometric radiographs were ev aluated. In unilaterally expanded mandibles, the ipsilateral condyle i ncreased in size and volume, became more upright, and was oriented in a more normal vertical axis. The contralateral unexpanded condyle did not show deformational changes. In those mandibles that were bilateral ly expanded, both condyles increased in size and volume and became mor e symmetrical and upright. Osteodistraction appears to affect bone in both local and distant sites. The expanded condyles were stimulated to ensure a more nearly normal shape, size, and configuration.