INTERACTIVE COURSE ON CD-ROM
TABLE OF CONTENTS

I. Introduction

Historically, different distraction osteogenesis techniques have been developed, including: 1) callotasis, which means distraction of the fracture callus, and 2) physeal distraction, which can be divided into either distraction epiphysiolysis or chondrodiatasis. This chapter provides definitions of distraction osteogenesis and histogenesis with a complete classification and description of distraction osteogenesis techniques.

II. Origins and Evolution

This chapter covers the origins of craniofacial distraction osteogenesis as it emerged based on the development and improvement of dentofacial traction, craniofacial osteotomies, and skeletal fixation methods. Later, modifications of these techniques were merged into osteodistraction procedures that were finally improved based on experiences with distraction osteogenesis from the long bones.

III. Devices and Techniques

This chapter demonstrates the currently available distraction appliances for craniofacial distraction osteogenesis, which includes both extraoral and intraoral devices. These devices can be further classified based on the method of fixation (tooth-borne, bone-borne, or hybrid) or the direction of distraction (uni-, bi-, or multi-directional). Different osteotomy techniques and distraction osteogenesis protocols are also analyzed for lengthening, widening, bone transport, and alveolar ridge augmentation.

IV. Biological Foundation

The successful application of osteodistraction is equally dependent on both biological and biomechanical factors. The biological principles of distraction osteogenesis, also known as the “Ilizarov Effects”, are described in this section of the CD-ROM. The distraction parameters include the osteotomy with maximal preservation of osteogenic tissues and blood supply, an adequate duration of the latency period, an optimal rate and rhythm of distraction, the length of the consolidation period, etc.

In addition, the biological mechanisms of new bone formation under the influence of gradual traction are demonstrated. This chapter includes a detailed histomorphological description of distraction bone regenerate formation and the sequence of adaptive changes that occur in the surrounding soft tissues. To enhance the text, an interactive microscope has been included to allow you to follow along with the text. The microscope provides zoom capabilities for each region of the presented histology slide.

V. Biomechanical Considerations

The biomechanical parameters of distraction osteogenesis can be divided into three categories: 1) extrinsic or fixator-related, 2) intrinsic or tissue-related, and 3) device orientation relative to the anatomical axis of distracted bony segments or to the common vector of distraction. This chapter defines the effects of device orientation in the transverse and sagittal planes during osteodistraction. The results of computer stimulation of mandibular distraction in the transverse and sagittal planes is enchanced with animations, as well as the results of animal studies that demonstrate the potential clinical problems associated with improper orientation of the distraction devices. The potential complications include bending or binding of the distraction devices, loosening of fixation screws, pathological changes at the mandibular condyles, and development of an anterior openbite.

VI. Clinical Applications

The library of case studies, collected from world-renowned experts in the field of distraction osteogenesis, demonstrates results of the clinical application of various craniofacial distraction techniques.

VII. Future Directions

The future development of osteodistraction for craniofacial applications will establish a more complete understanding of the biology of new bone formation under the influence of gradual traction. Major trends are explained in this chapter including refinement of distraction protocols, modification of osteotomy techniques, further improvement of distraction devices, enhancement of regenerate maturation with pharmacological agents, and development of new techniques for monitoring regenerate formation and remodeling.

VIII. References and Dictionary

The reference database of over 500 clinical and scientific papers and the distraction osteogenesis dictionary with 92 terms and definitions are both tightly integrated with the interactive lecture to provide an additional source of information for better understanding of the content.

IX. Search Engine

The built in Distraction Osteogenesis Search Engine allows keyword searches to find all pertinent information related to the specific distraction topic.

X. Interactive Distraction Osteogenesis Study Club

The CD-ROM is directly linked to the Interactive Distraction Osteogenesis Study Club at http://www.globalmednet.com/do, a web site developed by Globalmednet, Inc., that serves as an online communication forum offering a variety of information services related to osteodistraction. Recent experimental and clinical findings, as well as upcoming meetings, conferences and courses are posted so that members can stay abreast of the current knowledge in the field of distraction osteogenesis. In addition, the CMF Surgery Discussion Forum allows online consultation and the sharing of medical information about the latest techniques and interesting distraction cases. Using this link, you can also access the CD-ROM updates.

XI. CME/CDE Credits

The CD-ROM also provides a direct link to the Online CME/CDE Credit Center, where you can take a test for any particular CD-ROM chapter. This allows you to obtain CME/CDE credit from the comfort of your own home.

You will find an order form below. If you have any additional questions or comments, please don’t hesitate to contact us at cd-demo@globalmednet.com.

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