A Clinical Study Of Elastic Traction And Red And Blue Light Irradiation Assisted In The Treatment Of Hemifacial Shortness

Objectives This study including two parts.The first part is about using orthodontic elastic traction during the active period of distraction osteogenesis.Assess whether using elastic traction during the active period of Distraction osteogenesis can increase the effective vertical extension.The second part is about using red-blue light irradiation treatment to treat the postoperation wound.Postoperative infection is a complication of mandibular distraction osteogenesis(DO)in patients with hemifacial microsomia(HFM)..Evaluate the effectiveness of red-blue irradiation in the prevention of surgical wound infection after mandibular distraction.Methods1.Since May 2018,from 3 different clinical center,A total of 70 patients with Pruzansky-Kaban Type II mandibular deformity were recruited and randomly divided into two groups: Elastic traction+ Distraction Osteogenesis group and Distraction Osteogenesis group.During the active period,the experimental group received orthodontic Elastic traction 3 days after Distraction Osteogenesis implantation and the control group received no treatment.All subjects underwent a CT examination before surgery and at the end of active period of Distraction Osteogenesis,6 months,and 2 years after Distraction Osteogenesis tractor implantation.The effective vertical extension rates of the mandible from baseline to at the end of active period of Distraction Osteogenesis after the Distraction Osteogenesis surgery was the main measurement index and 7 secondary indices were used.2.Since august 2018,In our single-centered,randomized clinical study,118 patients diagnosed with hemifacial microsomia who had undergone distraction osteogenesis between April 2016 and April 2018 were included.The patients were randomly divided into two groups: the experimental group to receive red-blue irradiation treatment and the control group didn’t receive any light irradiation treatment.The experiment group receive 8 times red-blue light treatment during the active period of distraction osteogenesis(4 weeks post operation).This study estimated all patients’ wound picture at 4 weeks post operation and 6 months post operation.The secretion of patients’ facial wound was cultured.The infection rate of patients in active period of distraction osteogenesis(4 weeks post operation)was taken as the main evaluation index(wound infection evaluation: fever,wound redness,wound abscess secretion).The results were tested by t test.ResultsThe effective vertical extension rates of the mandible from baseline to the end of the active period were 85.0%±7.4% and 68.811%±9.5% in the experimental and control groups,respectively(P<0.01).At at the end of active period of DO after the DO surgery,the average distances of the lower incisor point and sagittal plane in the experimental and control groups were 2.485±1.411 mm and 3.938±2.293 mm,respectively.At the end of active period of DO after the DO surgery,the average cants of the mandibular occlusal plane in the experimental and control groups were-4.887±3.126 mm and-0.177±4.029 mm,respectively(P <0.01 for all)The average splint height in the experiment and control groups was 8.624±1.302 mm and3.203±1.011 mm,respectively.The difference between the two groups was statistically significant(P <0.01)The post-operative infection rate during the four weeks after DO in the experiment group was 1.7%,whereas that in the control group was 13.6%(P=0.016)(based on a modified NHSN infection wound criterion).Conclusion1.Elastic traction assisted Distraction Osteogenesis treatment during the active period can improve effective vertical extension rates and flatten the mandibular occlusal plane.2.Red-blue irradiation was effective in reducing the rate of post-operative wound infection after mandibular distraction using external distractors.