Documentation of the incidents associated with mandibular distraction: Introduction of a new stratification system

Pradip R. Shetye, Stephen M. Warren, Daniel Brown, Judah Garfinkle, Barry H. Grayson, Joseph G. McCarthy

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

BACKGROUND: This article aims to assess the spectrum of unfavorable events or incidents encountered during mandibular distraction and to evaluate the difference in the incident rates among the following treatment groups: (1) native bone distraction using an external device, (2) native bone distraction using an internal device, and (3) grafted bone distraction using an external device. METHODS: This retrospective study examined the records of 141 patients treated by mandibular distraction over a 16-year period. Of the total 141 patients, 56 underwent unilateral mandibular distraction and 85 underwent bilateral mandibular distraction, contributing to a total of 226 sided distraction procedures. The number of procedures performed on native bone using external devices was 149, versus 41 internal devices. There were 36 distractions performed on grafted bone with external devices. Incidents were broadly classified into three groups based on a severity index. A minor incident was one that resolved satisfactorily with minimal or no invasive intervention. A moderate incident was one that resolved satisfactorily with moderate clinical intervention. A major incident was one that did not resolve or could not be resolved with surgical intervention, and compromised treatment outcome. RESULTS: The major incident rate was 5.31 percent (total of 226 distraction procedures). A higher rate of major incidents was observed when distracting grafted bone. The overall minor incident rate was 26.99 percent and the moderate incident rate was 20.35 percent. CONCLUSION: Mandibular distraction can be considered a safe and predictable procedure for lengthening/augmenting the mandible in patients with lower jaw deficiencies.

Original languageEnglish (US)
Pages (from-to)627-634
Number of pages8
JournalPlastic and reconstructive surgery
Volume123
Issue number2
DOIs
StatePublished - Feb 1 2009
Externally publishedYes

Fingerprint

Documentation
Bone and Bones
Equipment and Supplies
Jaw
Mandible
Retrospective Studies

ASJC Scopus subject areas

  • Surgery

Cite this

Documentation of the incidents associated with mandibular distraction : Introduction of a new stratification system. / Shetye, Pradip R.; Warren, Stephen M.; Brown, Daniel; Garfinkle, Judah; Grayson, Barry H.; McCarthy, Joseph G.

In: Plastic and reconstructive surgery, Vol. 123, No. 2, 01.02.2009, p. 627-634.

Research output: Contribution to journalArticle

Shetye, Pradip R. ; Warren, Stephen M. ; Brown, Daniel ; Garfinkle, Judah ; Grayson, Barry H. ; McCarthy, Joseph G. / Documentation of the incidents associated with mandibular distraction : Introduction of a new stratification system. In: Plastic and reconstructive surgery. 2009 ; Vol. 123, No. 2. pp. 627-634.
@article{18d71e0330c845a198808a3fa80920bf,
title = "Documentation of the incidents associated with mandibular distraction: Introduction of a new stratification system",
abstract = "BACKGROUND: This article aims to assess the spectrum of unfavorable events or incidents encountered during mandibular distraction and to evaluate the difference in the incident rates among the following treatment groups: (1) native bone distraction using an external device, (2) native bone distraction using an internal device, and (3) grafted bone distraction using an external device. METHODS: This retrospective study examined the records of 141 patients treated by mandibular distraction over a 16-year period. Of the total 141 patients, 56 underwent unilateral mandibular distraction and 85 underwent bilateral mandibular distraction, contributing to a total of 226 sided distraction procedures. The number of procedures performed on native bone using external devices was 149, versus 41 internal devices. There were 36 distractions performed on grafted bone with external devices. Incidents were broadly classified into three groups based on a severity index. A minor incident was one that resolved satisfactorily with minimal or no invasive intervention. A moderate incident was one that resolved satisfactorily with moderate clinical intervention. A major incident was one that did not resolve or could not be resolved with surgical intervention, and compromised treatment outcome. RESULTS: The major incident rate was 5.31 percent (total of 226 distraction procedures). A higher rate of major incidents was observed when distracting grafted bone. The overall minor incident rate was 26.99 percent and the moderate incident rate was 20.35 percent. CONCLUSION: Mandibular distraction can be considered a safe and predictable procedure for lengthening/augmenting the mandible in patients with lower jaw deficiencies.",
author = "Shetye, {Pradip R.} and Warren, {Stephen M.} and Daniel Brown and Judah Garfinkle and Grayson, {Barry H.} and McCarthy, {Joseph G.}",
year = "2009",
month = "2",
day = "1",
doi = "10.1097/PRS.0b013e3181956664",
language = "English (US)",
volume = "123",
pages = "627--634",
journal = "Plastic and Reconstructive Surgery",
issn = "0032-1052",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

TY - JOUR

T1 - Documentation of the incidents associated with mandibular distraction

T2 - Introduction of a new stratification system

AU - Shetye, Pradip R.

AU - Warren, Stephen M.

AU - Brown, Daniel

AU - Garfinkle, Judah

AU - Grayson, Barry H.

AU - McCarthy, Joseph G.

PY - 2009/2/1

Y1 - 2009/2/1

N2 - BACKGROUND: This article aims to assess the spectrum of unfavorable events or incidents encountered during mandibular distraction and to evaluate the difference in the incident rates among the following treatment groups: (1) native bone distraction using an external device, (2) native bone distraction using an internal device, and (3) grafted bone distraction using an external device. METHODS: This retrospective study examined the records of 141 patients treated by mandibular distraction over a 16-year period. Of the total 141 patients, 56 underwent unilateral mandibular distraction and 85 underwent bilateral mandibular distraction, contributing to a total of 226 sided distraction procedures. The number of procedures performed on native bone using external devices was 149, versus 41 internal devices. There were 36 distractions performed on grafted bone with external devices. Incidents were broadly classified into three groups based on a severity index. A minor incident was one that resolved satisfactorily with minimal or no invasive intervention. A moderate incident was one that resolved satisfactorily with moderate clinical intervention. A major incident was one that did not resolve or could not be resolved with surgical intervention, and compromised treatment outcome. RESULTS: The major incident rate was 5.31 percent (total of 226 distraction procedures). A higher rate of major incidents was observed when distracting grafted bone. The overall minor incident rate was 26.99 percent and the moderate incident rate was 20.35 percent. CONCLUSION: Mandibular distraction can be considered a safe and predictable procedure for lengthening/augmenting the mandible in patients with lower jaw deficiencies.

AB - BACKGROUND: This article aims to assess the spectrum of unfavorable events or incidents encountered during mandibular distraction and to evaluate the difference in the incident rates among the following treatment groups: (1) native bone distraction using an external device, (2) native bone distraction using an internal device, and (3) grafted bone distraction using an external device. METHODS: This retrospective study examined the records of 141 patients treated by mandibular distraction over a 16-year period. Of the total 141 patients, 56 underwent unilateral mandibular distraction and 85 underwent bilateral mandibular distraction, contributing to a total of 226 sided distraction procedures. The number of procedures performed on native bone using external devices was 149, versus 41 internal devices. There were 36 distractions performed on grafted bone with external devices. Incidents were broadly classified into three groups based on a severity index. A minor incident was one that resolved satisfactorily with minimal or no invasive intervention. A moderate incident was one that resolved satisfactorily with moderate clinical intervention. A major incident was one that did not resolve or could not be resolved with surgical intervention, and compromised treatment outcome. RESULTS: The major incident rate was 5.31 percent (total of 226 distraction procedures). A higher rate of major incidents was observed when distracting grafted bone. The overall minor incident rate was 26.99 percent and the moderate incident rate was 20.35 percent. CONCLUSION: Mandibular distraction can be considered a safe and predictable procedure for lengthening/augmenting the mandible in patients with lower jaw deficiencies.

UR - http://www.scopus.com/inward/record.url?scp=61449211259&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=61449211259&partnerID=8YFLogxK

U2 - 10.1097/PRS.0b013e3181956664

DO - 10.1097/PRS.0b013e3181956664

M3 - Article

C2 - 19182623

AN - SCOPUS:61449211259

VL - 123

SP - 627

EP - 634

JO - Plastic and Reconstructive Surgery

JF - Plastic and Reconstructive Surgery

SN - 0032-1052

IS - 2

ER -