Experience with mandibular reconstruction using transport-disc-distraction osteogenesis

Area of Science:

• Oral and Maxillofacial Surgery
• Regenerative Medicine
• Biomaterials Engineering

Background:

• Severe mandibular defects pose reconstructive challenges, often requiring invasive procedures.
• Conventional methods may have donor site limitations or prolonged surgical times.
• Transport-disc-distraction osteogenesis (TDDO) utilizes in-situ bone for reconstruction.

Purpose of the Study:

• To evaluate the efficacy of TDDO in mandibular reconstruction.
• To report the first use of TDDO combined with dental implants and orthognathic surgery.
• To analyze outcomes in patients with severe segmental mandibular defects.

Main Methods:

• Retrospective analysis of mandibular reconstruction cases suitable for distraction (2006-2011).
• Inclusion of eight cases: six ameloblastomas, two gunshot fractures (defect size 45-60 mm).
• Protocol: 5-day latency, 19-45 day activation (avg. 30 days), 8-12 week consolidation.

Main Results:

• Mean distraction length achieved was 40.45 mm.
• TDDO facilitated bone regeneration and soft tissue provision.
• Reduced donor-site morbidity compared to traditional approaches.

Conclusions:

• TDDO is a valuable alternative for severe segmental mandibular defects.
• It enables anatomical bone regeneration and functional restoration.
• Patient education is crucial for optimizing outcomes with distraction devices.