Biomechanical and clinical implications of distraction osteogenesis in craniofacial surgery

Introduction: Craniofacial distraction osteogenesis is an established surgical procedure to correct bony malformations. Force transduction through the osteotomized bone fragments elicits defined biological responses in the gap tissue, which determines the clinical success of the distraction treatment. Objective: The purpose of this investigation was to evaluate clinically a new distraction protocol based on an analysis of the biological and biomechanical parameters executing direct effects on bone regeneration during distraction. Study design: A multistep distraction protocol was used in 39 patients and the clinical outcome was monitored postoperatively. Results: All the distraction cases were successful with a single exception. Segmental displacements were stable clinically and radiologically. Conclusion: In order to improve the clinical success of distraction osteogenesis, individual treatment protocols are recommended. (C) 2003 European Association for Cranio-Maxillofacial Surgery.