Mandibular deformities: single-vector distraction techniques for a multivector problem.

Area of Science:

• Craniofacial surgery
• Orthognathic surgery
• Pediatric plastic surgery

Background:

• Single-vector distraction devices have faced criticism for potentially causing malocclusion when correcting mandibular deficiency.
• The evolution towards multiplanar devices arose from concerns about malocclusion.
• However, single-vector devices can effectively treat many cases of mandibular hypoplasia.

Purpose of the Study:

• To describe surgical techniques for effectively using single-vector devices in treating multivector mandibular deficiency.
• To highlight the benefits of single-vector devices in specific patient populations.

Main Methods:

• Retrospective analysis of patients treated with semiburied, uniplanar devices at Children's Hospital of Philadelphia (1996-2005).
• Review of patient charts, photographs, operative reports, CT scans, and cephalometrograms.
• Analysis included 10 unilateral and 4 bilateral distractions across various etiologies.

Main Results:

• Successful treatment in 14 patients with conditions including hemifacial microsomia and Treacher Collins syndrome.
• Average distraction of 29 mm in patients aged 4-15 years.
• Demonstrated aesthetic correction of three-dimensional problems and maintenance of Class I occlusion.

Conclusions:

• Single-vector, semiburied devices are effective for aesthetically correcting three-dimensional mandibular deficiencies.
• These devices can produce or maintain a Class I occlusion.
• The technique simplifies postoperative management and minimizes facial scarring.