[Ostegenesis bifocal distraction as an alternative of mandibular reconstruction. A case report]

Mandibular continuity can be lost due to several factors. Whatever the cause, the restitution of the anatomy is important for aesthetic and functional purposes. Nowadays many graft techniques are available. Some of them have been shown to be successful in a lot of cases, nevertheless the osteogenic distraction should be considered as an alternative procedure to mandibular reconstruction. The osteogenic distraction can offer some advantages like a short surgical time, low morbidity, avoidance of the risk of graft rejection and also less vascular problems. Some of the disadvantages associated to this technique are that patients require longer follow-up periods. More patient cooperation is required also and finally, a risk of deviation of the distraction vector is also present, This kind of complication can increase the necessity of placing an external orthopedic device. An adequate management requires knowledge of both the bony biology and the possible biomechanical implications. Suitable planning of the osteogenic distraction procedure in combination with physical and psychological training of the patient can produce good aesthetic and functional results.