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Update on mandibular distraction osteogenesis

Earley, Marisaa; Butts, Sydney C.b

Current Opinion in Otolaryngology & Head and Neck Surgery: August 2014 - Volume 22 - Issue 4 - p 276–283
doi: 10.1097/MOO.0000000000000067
FACIAL PLASTIC SURGERY: Edited by Travis T. Tollefson

Purpose of review Mandibular distraction osteogenesis has become one of the most powerful reconstructive tools for addressing congenital lower jaw deformities. This review will focus on clinical and basic science contributions to the literature in the last year, which have shown innovations in mandibular distraction osteogenesis techniques and advances in outcomes.

Recent findings The longest phase of distraction is consolidation, when newly formed bone must fully heal. If consolidation could be accelerated, the length of time required for fixation would be less and complications associated with fixation devices would decline. In the last year, animal studies were conducted reporting the application of growth factors directly to distraction gaps to accelerate bone formation. Additional research in animal models showed success with the addition of bone marrow-derived mesenchymal stem cells to the distraction gap. Distraction devices are being piloted with automated, continuous formats compared with current devices that require manual activation. The use of surgical planning software programs to determine the location of osteotomies was another focus of current studies.

Summary Rates of activation can be accelerated with the addition of stem cells and growth factors to distraction sites, as could time to full consolidation. The addition of mesenchymal stem cells and deferoxamine and the use of low-intensity ultrasound during distraction are three of the most promising approaches reported in recent studies with potential for future translation from animal models. Computer-assisted presurgical planning offers added accuracy and potential time savings. Newer distraction devices using computer automation are still in preliminary phases, but show promise.

aDepartment of Otolaryngology

bDivision of Facial Plastic and Reconstructive Surgery, Downstate Medical Center, State University of New York, New York, USA

Correspondence to Dr Butts, MD, Chief, Department of Otolaryngology, SUNY Downstate Medical Center, 450 Clarkson Avenue, Box 126 Brooklyn, NY 11203, USA. Tel: +1 718 270 1638; fax: +1 718 270 3924; e-mail:

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins