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Do Patient-Specific Distractors and Cutting Guides Reduce Operative Time in Infants Undergoing Mandibular Distraction

Jeffrey S Marschall1, Logan Sardzinksi2, Jeffrey Schootman2

  • 1Assistant Professor, Department of Oral and Maxillofacial Surgery, University of Iowa Hospital and Clinics, Iowa City, Iowa.

Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons
|April 29, 2026
PubMed
Summary

Patient-specific hardware, including cutting guides and distractors, significantly reduces operative time for mandibular distraction osteogenesis (MDO) in infants. This improves surgical efficiency for treating airway obstruction due to micrognathia.

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Area of Science:

  • Craniofacial Surgery
  • Pediatric Surgery
  • Medical Device Technology

Background:

  • Mandibular distraction osteogenesis (MDO) treats upper airway obstruction in infants with micrognathia.
  • Patient-specific hardware, enabled by CAD/CAM, is increasingly used, but its impact on MDO operative time is not well-documented.

Purpose of the Study:

  • To evaluate if patient-specific cutting guides and/or distractors decrease operative time in MDO compared to stock distractors alone.
  • To assess the efficiency gains from incorporating digital planning and custom hardware in infant MDO procedures.

Main Methods:

  • Retrospective cohort study of infants undergoing MDO (2015-2026).
  • Compared operative times across three groups: stock distractors alone, stock distractors with patient-specific guides, and patient-specific distractors with patient-specific guides.
  • Linear regression analysis identified predictors of operative time, controlling for age, weight, sex, and syndromic diagnosis.

Main Results:

  • Forty infants were analyzed; median age was 75 days.
  • Median operative times were 232 minutes (stock alone), 184 minutes (stock guides), and 187 minutes (patient-specific guides).
  • Patient-specific guides (with stock or custom distractors) significantly reduced operative time (P=.024), with linear regression showing reductions of 52 and 43 minutes, respectively.

Conclusions:

  • The use of patient-specific cutting guides and distractors is associated with a clinically significant reduction in MDO operative time.
  • These findings support the routine adoption of digital planning and patient-specific hardware to enhance surgical efficiency in infants undergoing MDO.