Osteosynthesis and simultaneous irregular trifocal distraction osteogenesis for segmental mandibular defect after tumor ablative surgery: a case report

Objective. This paper describes a case of secondary mandibular bone reconstruction performed to place dental implants. Osteosynthesis and simultaneous irregular trifocal distraction osteogenesis were documented. Patient. The patient was a 51-year-old man with recurrent ameloblastoma of the mandible. Segmental mandibulectomy for tumor ablation and immediate mandibular reconstruction were performed. Because the volume of reconstructed bone was insufficient to place dental implants, trifocal distraction osteogenesis (vertical and horizontal distraction osteogenesis) was performed. Because the mandible had lost its continuity, osteosynthesis was performed simultaneously. Results. Through this procedure, the bone was well augmented. Absorption of the distracted bone was not seen. Adequate-length implants were placed. Conclusion. Irregular trifocal distraction osteogenesis synchronized with osteosynthesis shortened the treatment period and produced stable bone augmentation for placement of dental implants. Therefore, this procedure could be indicated for complicated segmental mandibular bone defects. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008; 106: 651-5)