Application of a novel intraorally customized transport distraction device in the reconstruction of segmental mandibular defect.
OBJECTIVE
The purpose of this study was to evaluate the clinical result of segmental mandible reconstruction by using a novel intraorally customized trifocal curvilinear distractor.


METHODS
A customized curvilinear distractor with self-locking system and bidirection transport assembly was designed on the basis of the mandibular contour of a patient diagnosed with ameloblastoma. Two transport disks, each containing the first molar, were designed for trifocal distraction osteogenesis after partial mandibulectomy intraorally. The latency period is 7 days and distraction rhythm is 1 mm/d. After 6 months of consolidation, the second operation was performed to remove the device.


RESULTS
A new bone bridged the mandibular defects through transport distraction successfully. Partial bony nonunion between the transport disks was noted when removing the distractor; rigid internal fixation using a titanium plate and bone graft was carried out to ensure the continuity. Bilateral sagittal split ramus osteotomy was performed to advance the mandible when anterior-posterior jaw bone discrepancy occurred before final denture restoration.


CONCLUSIONS
Customized trifocal curvilinear transport distraction osteogenesis can successfully reconstruct segmental mandible defect intraorally, but special consideration should be paid on the dock site bone healing and overcorrection of curvilinear reconstruction in the future.
From the Department of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai, China.
Ming
M
Cai
Xiaofeng
X
Lu
Danling
D
Yang
Huijuan
H
Cheng
Guofang
G
Shen
D000564:Ameloblastoma / Q000601:surgery*; D001860:Bone Plates; D016025:Bone Transplantation; D004867:Equipment Design; D005260:Female; D006801:Humans; D008334:Mandible / Q000601:surgery*; D019186:Mandibular Advancement; D008339:Mandibular Neoplasms / Q000601:surgery*; D063168:Mandibular Osteotomy; D008875:Middle Aged; D019857:Osteogenesis, Distraction / Q000295:instrumentation*; D059229:Osteotomy, Sagittal Split Ramus; D019651:Plastic Surgery Procedures / Q000295:instrumentation*; D012086:Reoperation; D014025:Titanium
D014025:Titanium