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J Oral Maxillofac Surg. 2004 Apr;62(4):412-20.

Use of a plate-guided distraction device for transport distraction osteogenesis of the mandible.

Author information

1
Division of Oral and Maxillofacial Surgery, Loma Linda University Medical Center, Loma Linda, CA, USA. aherford@sd.llu.edu

Abstract

BACKGROUND:

Transport distraction osteogenesis has been used to reconstruct continuity defects by regenerating bone and soft tissues. A challenge has been to maintain the correct vector during the distraction process. A new type of distraction device was recently developed that uses a standard reconstruction plate to "guide" the transported segment of the bone. This plate-guided distractor device (PGD) intimately follows the shape of the plate, thus allowing for 3-dimensional vector control during the distraction process.

PATIENTS AND METHODS:

Four patients underwent transport distraction osteogenesis for reconstruction of segmental mandibular defects ranging in size from 4 to 7 cm. The age of the patients ranged from 27 to 62 years. Two patients had been treated with radiotherapy as part of treatment for oral malignancy. A standard locking reconstruction plate was placed to bridge the continuity gap. An osteotomy was performed to create a bone transport segment. The PGD was secured to both the reconstruction plate and the transport bone. After a latency period of 7 days, the device was activated at a rate of 1 mm/d. The distraction process continued until the transport segment reached the opposing bone or sufficient bone and soft tissue were reconstructed for oral rehabilitation.

RESULTS:

All patients achieved hard and soft tissue formation. Two patients had premature consolidation of the distraction regenerate but had sufficient tissue for rehabilitation.

CONCLUSION:

A PGD can be used to regenerate missing hard and soft tissues. An advantage of this technique is that it uses a reconstruction plate that is routinely placed to bridge mandibular continuity defects. This device allows for ultimate vector control by intimately following a carefully adapted plate.

PMID:
15085505
[Indexed for MEDLINE]

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