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Updated: Mar 7, 2026
A Postoperative Evaluation Guideline for Computer-Assisted Reconstruction of the Mandible
Published on: January 28, 2020
Curvilinear Segmental Mandibular Reconstruction Utilizing Distraction Osteogenesis and Early Open Callus Manipulation
Alberto Rocha Pereira1, Paulo Neves1, José Rosa1
1Plastic, Reconstructive & Maxillofacial Surgery Unit, Hospital das Forças Armadas, Paço do Lumiar, Lisbon, Portugal; Plastic and Reconstructive Surgery Unit, Instituto Português de Oncologia Francisco Gentil, R. Prof. Lima Basto, Lisbon, Portugal; and Plastic and Reconstructive Surgery Division, The Children's Hospital of Philadelphia, Philadelphia, Pa.
This study introduces a novel mandibular reconstruction technique using distraction osteogenesis and callus manipulation. It successfully restored large defects without bone grafts, offering a valuable alternative for patients.
Area of Science:
- Oral and Maxillofacial Surgery
- Regenerative Medicine
- Biomaterials Engineering
Background:
- Large curvilinear mandibular defects pose significant reconstruction challenges.
- Current methods like bone grafting and free flaps have limitations.
- A need exists for innovative, less invasive reconstruction techniques.
Purpose of the Study:
- To present and evaluate a new technique for reconstructing large mandibular defects using distraction osteogenesis and early open callus manipulation.
- To demonstrate the efficacy of this technique in achieving stable, functional, and aesthetically pleasing mandibular reconstruction.
- To establish bone transport as a viable alternative to conventional reconstructive methods.
Main Methods:
- Phase 1: Creation of mandibular bone transport disks and distraction across the defect without plate fixation.
- Phase 2: Open manipulation, repositioning, and fixation of transported segments in the ideal tridimensional position.
- Early removal of distractors to shorten consolidation and overall treatment time.
Main Results:
- Successful reconstruction of large (6-cm and 7-cm) mandibular defects in two patients without bone grafting.
- Achieved stable, long-term reconstruction with good facial symmetry and no complications five years post-surgery.
- Demonstrated shortened consolidation phases and reduced total treatment duration.
Conclusions:
- The presented technique of distraction osteogenesis with early open callus manipulation is effective for reconstructing large curvilinear mandibular defects.
- This method offers a valuable alternative to bone free flaps, providing stable and aesthetically superior results.
- The technique simplifies reconstruction, reduces treatment time, and avoids the need for autologous bone grafts.
