Reconstruction of segmental mandibular defects by distraction osteogenesis for mandibular reconstruction

Abstract

Mandibular reconstruction with distraction osteogenesis is a potentially useful technique in selected patients with segmental mandibular continuity defects after ablative head and neck cancer surgery.

Biomechanical Configurations of Mandibular Transport Distraction Osteogenesis Devices

“…54 Monofocal distraction does not have tissue discontinuities, whereas bone transport often has concomitant soft tissue losses. Bone transport has five stages instead of the four monofocal stages, adding a docking site osteogenesis stage 8,20,26,30 after the distraction period and in parallel with the consolidation period.…”

“…5): power screw, 1,8,9,15,[17][18][19][20][21][22][23]26,[28][29][30][31][32]42,45,54 spring, 24,25,55 traction wire, 14,16 hydraulic, 27 and rack and pinion. 2,56 The power screw activation system, also called screw lead activation system, translates torque into linear force to be used to distract the mandibular bone by matching an external helical threaded screw with either a negative or female threaded nut with the same thread form (Fig.…”

“…The average length that can be distracted by using internal MBT devices with power screw activation systems is 40 mm, 9,15,[18][19][20]47 and 50 mm of distraction by using external MBT devices. 26,30,54 A novel MBT device, which combines the power screw activation mechanism with the stabilizing reconstruction plate to form a bone transport reconstruction plate unit, has recently been developed. 42 Combining the MBT and reconstruction plate reduces the size of the internal device and increases the stability of the transport unit.…”

“…81 Defects can be located on the condyle, Although the condyle, ramus, and body anatomical positions are able to receive either unilateral or bilateral MBT devices, most of the MBT devices are applied to only one side of the mandible, [14][15][16][17]25 and only one MBT device has been successfully used bilaterally. 28,54 According to reports in the literature, most of the MBT devices for use across the symphysis are external (Table 1). Currently, few internal MBT devices for the symphysis have been tested in animal 31 and human 16,17,57 subjects, because the reconstruction of the curved mandibular symphysis is challenging.…”

Reconstruction mandibulaire en cancérologie : état actuel et perspectives

“…Son utilisation pour la reconstruction segmentaire est plus confidentielle. En plus des deux surfaces osseuses, un fragment intermé diaire est cré é et dé placé dans le dé faut osseux par un dispositif mé canique externe [54,55] ou interne [56]. Ainsi, les surfaces et les espaces de né oformation osseuse sont augmenté s. L'avantage de cette technique est de permettre la croissance du tissu osseux mais aussi des tissus mous avoisinants.…”