Controlled multiplanar distraction of the mandible: device development and clinical application

Area of Science:

• Craniofacial surgery
• Biomedical engineering
• Regenerative medicine

Background:

• Distraction osteogenesis effectively lengthens endochondral bone and reconstructs craniofacial membranous bones.
• Clinical experience highlights limitations of uniplanar distraction for three-dimensional mandibular reconstruction, impacting functional and structural requirements.
• Uniplanar distraction inadequately addresses malocclusion and skeletal/soft tissue deficiencies in the mandible.

Observation:

• A novel multiplanar mandibular distraction device was developed and clinically utilized.
• The device enables independent linear (sagittal), angular (vertical), and transverse (coronal) distraction.
• It features two independent gear arrangements on arms extending from a central unit, allowing trajectory modification during bone regeneration.

Findings:

• The multiplanar device allows customization of regenerated bone dimensions by controlling translation trajectory.
• Independent manipulation of movement planes enhances surgical precision.
• A single rotational point simplifies the procedure, requiring only one osteotomy and two pin sites.

Implications:

• This device offers enhanced three-dimensional reconstruction capabilities for deficient mandibles.
• It improves the potential for achieving optimal functional and structural outcomes in craniofacial reconstruction.
• The multiplanar approach represents a significant advancement in treating complex mandibular deformities.