Internal distraction osteogenesis with a unidirectional device for reconstruction of mandibular segmental defects

Purpose: To present the authors' clinical experience with unidirectional internal distraction devices to reconstruct mandibular defects. Patients and Methods: Five patients have been treated with mandibular distraction osteogenesis to reconstruct different acquired segmental defects. These mandibular defects (35 to 80 mm in length) were reconstructed by means of internal distraction devices with a transcutancous activator. All the patients underwent complete resection of the affected bone and immediate placement of the distraction device on the remaining mandible. Results: The results' analysis was based on clinical observation, postoperative radiographs, histopathologic findings and 3-dimensional computed tomographic scans. Successful distraction osteogenesis was achieved in 3 cases. In 1 case, extensive intraoral exposure of the device was observed, resulting in a failure of the procedure. One patient died of distant metastases 4 months after the resective surgery. Conclusion: Because of the limited number of cases, this study is preliminary. However, considering the good experimental and clinical results, this new technique offers an alternative for patients with segmental mandibular defects in which, because of local or general reasons, a more aggressive procedure should be avoided. (c) 2005 American Association of Oral and Maxillofacial Surgeons.