Dj. Annino et al., DISTRACTION OSTEOGENESIS FOR RECONSTRUCTION OF MANDIBULAR SYMPHYSEAL DEFECTS, Archives of otolaryngology, head & neck surgery, 120(9), 1994, pp. 911-916
Objective: We investigated the feasibility of arced trifocal distracti
on osteogenesis for reconstruction of mandibular symphyseal defects. D
esign: Four adult canine subjects were used. An external apparatus was
designed to allow trifocal distraction around an are. An anterior man
dibulectomy was performed between the third premolars bilaterally. The
bony defect was regenerated using trifocal distraction osteogenesis a
t a rate of 1 mm a day bilaterally. New arced bone was produced over a
period of 20 to 35 days. The apparatus functioned as an external fixa
tor for the ensuing 6 weeks. The apparatus was then removed, the dogs
were returned to their preoperative diet, and were killed after 2 week
s of observation. Main Outcome Measures: Grossly a smooth arc of bone
was formed measuring 4.5 to 5.5 cm in length, 2.2 to 3.0 cm in height,
and 1.3 to 1.5 cm in width. Histologically all specimens demonstrated
direct membranous bone growth. Radiographically opaque columns were s
een streaming in the direction of distraction. Conclusions: Symphyseal
bony defects resulting from oncologic resection, trauma, and congenit
al deformities create tremendous cosmetic and functional handicaps and
have remained extremely challenging to surgically reconstruct. This s
tudy demonstrates the ability to use arced trifocal distraction osteog
enesis to reconstruct anterior mandibulectomy defects in a canine mode
l. This method may provide a satisfactory solution to a difficult prob
lem in human mandibular reconstruction.