Craniofacial distraction osteogenesis: a review of the literature. Part 1:clinical studies

A review of the literature dealing with distraction osteogenesis (DO) of th e craniofacial skeleton, provided by a PUBMED search (National Library of M edicine, NCBI; revised 3 April 2000) from 1966 to December 1999 was conduct ed. Key words used in the search were distraction, lengthening, mandible, m andibular, maxilla, maxillary, midface, midfacial, monobloc, cranial, crani ofacial and maxillofacial. This search revealed 285 articles. One hundred a nd nine articles were clinically orientated and were analysed in detail in this study. The type of distraction, indications, age, type of surgery, dis traction rates and rhythms, latency and contention periods, amount of lengt hening, follow-up period, relapse, complications and the nature of the dist raction device were analysed. This review revealed that 828 patients underw ent DO of the craniofacial skeleton; 579 underwent mandibular DO, 129 maxil lary DO, 24 simultaneous mandibular and maxillary DO and 96 midfacial and/o r cranial DO. Craniofacial DO has proven to be a major advance for the trea tment of numerous congenital and acquired craniofacial deformities. Treatme nt protocols and success criteria for craniofacial DO are suggested on the basis of these results. There is still, however, a lack of sufficient data, especially on follow-up and relapse, so that treatment strategies have to be validated by long-term studies in the future.