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Curvilinear Mandibular Distraction Results and Long-Term Stability Effects in a Group of 40 Patients

Aizenbud, Dror D.M.D., M.Sc.; Hazan-Molina, Hagai D.M.D.; Thimmappa, Brinda M.D.; Hopkins, Elena M. R.N., M.S., P.N.P.; Schendel, Stephen A. M.D., D.D.S.

Plastic and Reconstructive Surgery: June 2010 - Volume 125 - Issue 6 - p 1771-1780
doi: 10.1097/PRS.0b013e3181d9937b
Pediatric/Craniofacial: Original Articles

Background: The mandibular internal curvilinear distractor design produces a curvilinear vector to provide ideal three-dimensional curvilinear movements compared with the limited straight unidirectional predecessor devices. In this manner, it corrects craniofacial deformities as anatomically as possible, allowing simultaneous bidirectional (rotational and translational) mandibular movement and multidirectional distraction. The aim of this study was to quantify the sagittal and vertical mandibular changes achieved through curvilinear distraction and to assess the long-term effect of this generated bone.

Methods: Forty patients (20 male and 20 female), with ages ranging from 5 to 55 years, who underwent mandibular distraction from December of 1999 to August of 2007 at Lucile Packard Children's Hospital in Stanford, California, were included. Preoperatively, postoperatively, and at follow-up (at least 2 years following distraction), panoramic and lateral cephalometric radiographs were traced by plotting different skeletal landmark points and were then analyzed.

Results: All patients tolerated the curvilinear distraction process well through completion. The average of the mandibular body elongation recorded was 8 to 9 mm and 6 to 8 mm in the panoramic and cephalometric radiographs, respectively; whereas the vertical change of the mandibular ramus achieved was 10 to 12 mm and 10 to 11 mm, respectively. The curvilinear distraction effect on the mandible was found to be significantly stable when the long-term follow-up measurements were compared with the postoperative data revealed in the panoramic and lateral cephalometric radiographs for the two dimensions.

Conclusion: The internal curvilinear device is an effective tool that achieves a stable mandibular distraction, resulting in the correction of craniofacial deformities.

Haifa, Israel; and Palo Alto, Calif.

From the Orthodontic and Craniofacial Center, Rambam Health Care Campus and Technion Faculty of Medicine, and the Craniofacial Anomalies Center, Packard Children's Hospital, Stanford University School of Medicine.

Received for publication September 15, 2009; accepted November 12, 2009.

Disclosure: No one sponsored this article. The senior author (S.A.C.) receives royalties from and is a consultant to Osteomed Corp. The other authors have no potential conflict of interest; none of them received an honorarium, grant, or other form of payment.

Dror Aizenbud, D.M.D., M.Sc., Orthodontic and Craniofacial Center, Rambam Health Care Campus, P.O. Box 9602, Haifa 31096, Israel,

©2010American Society of Plastic Surgeons