title: Calvarial reshaping using bifocal bidirectional transport distraction osteogenesis.
abstract: OBJECTIVE
  The aim of this study is to assess 3-dimensional reconstruction of cranial defects by use of bifocal bidirectional transport distraction osteogenesis (BBTDO).
  
  
  METHODS
  This study was performed on 8 sheep, divided into a control group (n = 3) and treatment group (n = 5). Full-thickness cranial defects (50 x 40 mm) were created on calvaria. In the control group only the skin was closed. In the treatment group BBTDO was performed. Distraction was performed with a custom-made distraction device with a transport segment of 40 x 20 mm. After a 5-day period of latency, distraction was applied to the transport segment. During the first 20 days of distraction, the transport segment was distracted 1 mm in the forward direction and 0.5 mm in the upward direction. After the next 20 days of distraction, the transport segment was distracted 1 mm forward and 0.5 downward. After a total of 40 days' distraction, a 30-day consolidation period was applied. Macroscopic, radiologic (computed tomography with volume measurements), and histologic evaluations were done.
  
  
  RESULTS
  No major complications were seen during the whole study period. In the control group the bone defects remained unhealed at the end of the study period. The same-sized defects in the treatment group healed with a convexity like the calvaria. Preoperative and postoperative cranial volume measurements of the treatment group animals showed an increase in cranial volume (P < .05). Histologic evaluation showed inductive bone regeneration and mature bone structure development within the distraction zone.
  
  
  CONCLUSIONS
  The BBTDO is an effective and safe technique for 3-dimensional closure of cranial defects.
authors: Diyarbakir Military Hospital, Diyarbakir, Turkey.
authors: Muzaffer
authors: M
authors: Durmus
authors: Fatih
authors: F
authors: Zor
authors: Serdar
authors: S
authors: Ozturk
authors: Ugur
authors: U
authors: Bozlar
authors: Murat
authors: M
authors: Turegun
authors: Mustafa
authors: M
authors: Sengezer
mesh_terms: D000818:Animals; D015519:Bone Density; D001861:Bone Regeneration; D003399:Craniotomy / Q000295:instrumentation / Q000379:methods*; D019857:Osteogenesis, Distraction / Q000295:instrumentation* / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000295:instrumentation / Q000379:methods; D034561:Sheep, Domestic; D012886:Skull / Q000601:surgery*; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed / Q000379:methods