[Mandibular reconstruction of gunshot wounds by progressive bone distraction. Report of five cases]

Five adult patients with gunshot wound defect underwent bilateral mandibular lengthening by an extraoral device. All patients presented with interrupting mandibular defect of 50 to 100 mm. Distraction of bone fragments led to mandibular reconstruction without bone grafting and simultaneous expansion of soft tissues, avoiding free or pedicled myocutaneous flaps for soft tissue reconstruction of the lower third of the face. Mandibular distraction also recreated the alveolar ridge with its attached mucosa which is equivalent to the gingiva. It can be used for dental rehabilitation by osseointegrated implants. Avoiding the morbidity and functional problems of classical flaps, mandibular distraction accelerates facial reconstruction, and social reinsertion of these patients.