Distraction osteogenesis (DO), a useful

technique to generate bone and soft tissue

can be applied to craniofacial reconstruction
Orthognathic Surgery,
Cleft lip And Palate Reconstruction,
Mandibular Condyle Regeneration,
Dentoalveolar Unit Reconstruction For
Implants
Transport DO for discontinuity defects.

The distraction technique involves creating

an osteotomy in an area adjacent to
an area of bone deficiency.
Applying slow tension forces separates the
bony edges, which creates a regenerate
chamber from
which the new bone and soft tissues are
formed

These 5 principles are key to success

1. Osteotomy

2. Latency period:
3. Distraction rate

4. Distraction rhythm:
5. Consolidation:

Corticotomy
is a low - energy osteotomy of the cortex
preserving the local blood supply to both
the periosteum and the medullary canal.

Latency
is the time following the osteotomy
when initial fracture healing bridges the cut
bone surfaces prior to initiating distraction
3, 5, or 7 days,
depending on the surgical site

ROME 2008 SRDC

Rate
is the number of millimeters per day at
which the bone surfaces are stretched.
: 1.0 mm per day (0.52.0 mm)

ROME 2008 SRDC

Rhythm
continuous forceapplication is best, yet
device activation bid is more practical and
allows
for better patient compliance
is the number of distractions per day,
usually in equally divided increments to
total the rate

Transformation osteogenesis consolidation

until a cortical outline
can be seen radiographically across
the distraction gap, usually 6 weeks
is the conversion of nonosseous
interposition ( eg, fibrocartilage in nonunion,
synovial cavities in pseudarthritis, or muscle in
delayed unions) into normal bone by combined
compression and distraction forces, sometimes
augmented by nearby corticotomy.

ROME 2008 SRDC

To lengthen mandible unifocal

Transport segment bifocal
Reconstruction of symphysis - trifocal

ROME 2008 SRDC

simple corticotomy
For unilateral or
bilateral lengthening
Single vector

ROME 2008 SRDC

ROME 2008 SRDC

ROME 2008 SRDC

ROME 2008 SRDC

Block et al -alveolar distraction in experimental

animal.
Chin and Toth- 1st Distraction of alveolus

ROME 2008 SRDC

ROME 2008 SRDC

Alveolar distraction

ROME 2008 SRDC

Unilateral transport to fill a

defect

Proposed surgical defect

ROME 2008 SRDC

ROME 2008 SRDC

ROME 2008 SRDC

ROME 2008 SRDC

Bilateral transport to
reconstruct a
symphyseal defect

was developed to meet the clinical need for a distraction device

that corrects severe maxillary bone deficiencies in both the A-P
and vertical directions.
Indications
Distraction of the maxilla utilizing a LeFort I osteotomy in adult
and pediatric populations
Craniofacial surgery
Reconstructive procedures
Selective orthognathic surgery of the maxilla

External Pin Fixator Device

External Pin Fixator Device

Fixator
Fixator
component
to the transport
disc
component
to the
Anchorage Pin
Anchorage
Anchorage
fixators Pin
Guidance
rod

Anchorage fixators
Guidance rod

transport disc