 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
PBHS Webdesign
Copyright 1999
Surgical Cases
1. Alveolar Distraction
The patient, E.S., is a healthy 24-year-old female who had a central giant cell granuloma removed in December 1998. She has recovered well and is currently 15 months disease free. She is now prepared for reconstruction of her mandibular alveolus using distraction osteogenesis.
click on an image for a larger view
Patient ES had her distraction device activated 1mm per day until sufficient alveolar height was achieved. The distraction rod was removed 4 weeks later. Implants were placed 4 months after the initial surgery, then restored 5 months later. a. Maxillary Le Fort I osteotomy with impaction of the maxilla
2. Mandibular Advancement
The patient, P.B., is a healthy 36-year-old female presenting with a diagnosis of mandibular retrognathia, microgenia and vertical maxillary excess. Treatment plan for this patient included:
b. Bilateral ramus osteotomies and placement of bilateral distraction devices
c. Genioplasty.
click on an image for a larger view
 |
 |
 |
|
|
|
|
 |
 |
|
|
|
EIGHT MONTHS AFTER SURGERY
|
The patient underwent the surgical procedure without event on May 8th and has recovered well from her surgery.
3. Mandibular Regeneration using Transport Disc Distraction Osteogenesis (TDDO)
Our patient is a 25-year-old healthy female who initially presented to our office in August of 1997 regarding a large tumor in her right lower jaw. Biopsy of the tumor determined it to be a MYXOMA. The tumor was removed in September of 1997
In January of 1998 the patient’s lower jaw was reconstructed using an irradiated cadaver mandible and bone graft from her hip. This failed secondary to infection and in December of 1998 the entire graft was removed.
In May of 2000 the patient was taken back to the operating room and while she was under general anesthesia part of the remaining lower jaw was cut to make a transport disc. This disc was then transported 30 mm using an intraoral distraction device developed by the Stryker-Leibinger Corporation (Phase I). Once the device had reached its limit the patient was taken back to the operating room and the transport disc was cut in half One half was secured to the reconstruction bar and the other half was affixed to the distraction device. This half was then transported another 30 mm (Phase ll).The remaining part of the patient’s lower jaw was reconstructed using a hip graft.
The patient is currently 18 months post placement of implants and doing well. Restoration of the dental implants was done by Dr. Warren Bern of Woodstock, Georgia
For question about this case please contact Dr. Mac Whitesides @ doctormac@mindspring.com or Dr. Robert Wunderle @ rcwunderle@aol.com
We would also like to express our deep appreciation to Dr. Cesar Guerrero of Caracas, Venezuela and Dr. Bill Bell of Dallas Texas for the contributions in the treatment planning and care of this patient.
 |
 |
 |
|
|
|
|
 |
 |
 |
|
|
P.K. reconstruction of lower jaw using TDDO.
Beginnig of Phase 1 |
P.K. Reconstruction of lower haw using TDDO. End of Phase I.
|
 |
 |
 |
|
|
|
|
 |
 |
 |
|
|
P.K. Reconstrcuted lower jaw using TDDO (view from above)
|
Panorex of Dental Implants
|
 |
||
|
Clinical photo of patient's current dentition.
|
4.Hemifacial Microsomia
Case 1: Patient A.H.
 |
 |
 |
|
|
|
|
 |
 |
 |
|
|
A.H. photo of patient’s face after phase I distraction surgery
|
A.H. panorex of patient after phase II distraction surgery is complete (done 18 months after phase I)
|
 |
||
|
A.H. photo of patient’s face after phase II distraction surgery is complete (done 18 months after phase I)
|
Case 2: Patient M.M.
 |
 |
 |
|
|
|
|
 |
 |
 |
|
|
M.M. photo of patient’s face 18 months after distraction surgery
|
M.M. photo of patient’s bite 18 months after distraction surgery (note asymmetry is absent)
|
Lee M. Whitesides, DMD, MMSc