Mandibular distraction osteogenesis: a systematic review of stability and the effects on hard and soft tissues

Mandibular distraction osteogenesis (MDO) has been widely adopted in modern maxillofacial surgery due to its less invasive approach and the consistent aesthetic and functional improvements obtained. The aim of the present systematic review was to analyze the available evidence on the skeletal and soft tissue effects of MDO. The medical literature was searched to identify all peer-reviewed papers meeting the selection criteria for the final review process. A three-point grading system was used to rate the methodological quality of the selected papers. The PICO approach was used to extract data from the selected papers. The search strategy yielded eight relevant publications. The quality of the collected evidence was low to moderate. Vertical and sagittal skeletal dimensions increased significantly, by a mean of 5-10 mm (P < 0.05). Regarding the sagittal positioning of the lips and surrounding structures, a 90% correspondence between skeletal and soft tissue cephalometric points was observed. Significant skeletal relapse was reported, however it did not worsen the results of treatment significantly.