The First Decade of Mandibular Distraction: Lessons We Have Learned

Authors:
  • JMJoseph G. McCarthy
    Joseph G. McCarthy
  • JKJ. Timothy Katzen
    J. Timothy Katzen
  • RHRichard Hopper
    Richard Hopper
  • BGBarry H. Grayson
    Barry H. Grayson
Publisher website
Google Scholar
Abstract
Ilizarov 1 is credited with demonstrating the scientific basis and clinical efficacy of distrac- tion of the long bones of the extremities. The results of his work were later applied to the craniofacial skeleton. In a preliminary canine experiment, Snyder et al. 2 created a crossbite by removing a 1.5-cm segment of the mandible; they subsequently distracted the mandible back to its original position using a modified external fixator. After a delay of 1 week postostectomy, the mandibular segment was distracted at the rate of 1 mm a day for 14 days. Fixation was maintained for an additional 4 weeks. The concept was further developed in the canine model by Michieli and Miotti, 3 who in 1977 performed a unilateral mandibular os- teotomy to create an anterior crossbite. The mandible was lengthened approximately 15 mm at a rate of 0.5 mm per day, followed by 40 days of fixation. In this study, an intraoral dis- traction device was used, and histologic study demonstrated bony consolidation at the dis- traction site. A series of experiments from our laboratory demonstrated that the mandible could be lengthened successfully after a unilateral angu- lar osteotomy and subsequent distraction. 4 Af- ter a 10-day latency period, the canine mandi-

This publication has 11 references indexed in Scilit: