Long-term stability after craniofacial distraction osteogenesis.

PURPOSE: This study was conducted to systematically review long-term skeletal stability after craniofacial distraction osteogenesis. MATERIALS AND METHODS: Several electronic databases (Old Medline, Medline, Medline In-Process and Other Non-Indexed Citations, Pubmed, Embase, Web of Science, and all EBM reviews [Cochrane Database of Systematic Reviews, ACP Journal Club, DARE, and CCTR]) were searched. Key words used in the search were "distraction," "osteogenesis," "craniofacial," "maxillofacial," "stability," "relapse," and "recurrence." MeSH terms and truncations of these terms were selected with the help of a health science librarian. Abstracts that appeared to contain at least 3 years of postsurgical data were selected. The original articles were then retrieved and evaluated to ensure that they actually had 3 years of data after craniofacial distraction osteogenesis. The references were also hand-searched for possible missing articles that were not indexed in the searched databases. RESULTS: A total of 118 abstracts were found in the electronic searches. After the first set of selection criteria was applied on these abstracts, 22 articles were retrieved. After the final selection criteria were applied on these 22 articles, only 6 articles were finally selected. These 6 articles reported long-term stability after craniofacial distraction osteogenesis. Sample sizes were small, and the methodological quality of the studies was poor. CONCLUSIONS: Although, based on the selected studies, craniofacial bone distraction osteogenesis appeared to show long-term stability; limitations of the studies merit caution in interpreting these findings. Some early relapse occurred in the first 3 years postdistraction, but stability was maintained thereafter. Some methodologically sounder studies are needed to confirm the present findings.