Resorbable distraction of the mandible: technical evolution and clinical experience

The author has used various designs of single-stage resorbable distractors to lengthen the mandible in 100 patients aged 7 days to 16 years (mean, 4.24 y; 49 girls, 51 boys) with predictable results and minimal morbidity since 2002. The range of distraction was 15 to 30 mm (mean, 25.4 mm). Indications for surgery included mandibular hypoplasia associated with Pierre Robin sequence, craniofacial microsomia, Treacher Collins, and Nagers syndrome. The history of the development of resorbable polymers for use in craniofacial surgery and the evolution of distraction osteogenesis are reviewed. The melding of these 2 innovative technologies has led to the development of a new class of single-stage resorbable devices. These devices are quite different from the titanium distraction devices that have been used in clinical practice for more than 15 years. Through continued clinical application, the surgical methodology for resorbable distraction has been refined and simplified, although still-evolving continued experience with resorbable distraction has greatly decreased operative time and improved results.