Introduction of "vario plates" for retention after mandibular distraction osteogenesis

This report introduces a new removable orthodontic appliance called "vario plates" for retention following distraction osteogenesis of the mandible. The "vario plates" consist of removable orthodontic appliances in the maxilla and the mandible. These are fabricated out of self-curing resin with typical wire elements. They are connected with telescoping maxillomandibular guidance rods, which have a smoothly variable length, from the maxillary molar region to the mandibular premolar region on each side. The telescope on both sides is adjustable in this length by means of a protrusion nut. Thus, it is possible to move the mandible forward an exactly controlled amount. The "vario plates" are in function for 24 hours a day in the patient for the first 6 months after mandibular distraction osteogenesis and subsequently only at night. The application of the plates is demonstrated in a patient with Goldenhar syndrome. Application of "vario plates" after distraction osteogenesis makes it possible to hold the mandible in a stable position. The combination of maxillofacial surgery with distraction osteogenesis and orthodontic treatment and retention leads to an improvement in therapy of patients with severe dentofacial anomalies.