title: Customized bifocal and trifocal transport distraction osteogenesis device for extensive mandibular reconstruction.
abstract: OBJECTIVE
  The objective of this study was to report the use of custom-made transport distraction osteogenesis (TPDO) in reconstruction of extensive mandibular defect.
  
  
  METHODS
  Two consecutive patients with mandibular defect involving the body and symphysis were described. Presurgical three-dimensional computed tomography and rapid prototype model were used to design the customized distractor. A bifocal TPDO was performed as immediate reconstruction after mandibulectomy. The trifocal TPDO was carried out 2 years after partial mandibulectomy as a secondary procedure. Postoperatively, patients were followed up with clinical examinations and radiographs. The distractors were removed at the end of 8 months of consolidation period.
  
  
  RESULTS
  Both distractors were tolerated well. Both patients had achieved soft- and hard-tissue formation. A mild infection and unexpected unilateral coronoid fracture was noted in one of the patients. However, no functional disturbance to the distractor and no adverse impact on the final result were noted.
  
  
  CONCLUSIONS
  The use of custom-made TPDO distractor can recreate the mandibular contour in single-stage surgery and avoid the donor-site morbidity. It is a potentially valid method for extensive mandibular defect reconstruction.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Shanghai Ninth People's Hospital, and School of Medicine, Shanghai Jiaotong University, Shanghai, People's Republic of China.
authors.forename: Ming
authors.initials: M
authors.lastname: Cai
authors.forename: Xiaofeng
authors.initials: X
authors.lastname: Lu
authors.forename: Guofang
authors.initials: G
authors.lastname: Shen
authors.forename: Xudong
authors.initials: X
authors.lastname: Wang
authors.forename: Andrew Hua-an
authors.initials: AH
authors.lastname: Cheng
mesh_terms: D000328:Adult; D000564:Ameloblastoma / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008336:Mandibular Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D008339:Mandibular Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D009807:Odontogenic Cysts / Q000000981:diagnostic imaging / Q000601:surgery*; D019857:Osteogenesis, Distraction / Q000295:instrumentation*; D011474:Prosthesis Design; D011862:Radiography, Panoramic; D014057:Tomography, X-Ray Computed