Clinical Controversies in Oral and Maxillofacial Surgery: Part Two

Distraction osteogenesis is a powerful technique for creating new bone during significant lengthening of the mandible without the need for bone grafting and associated donor site morbidity. The majority of clinical applications of mandibular lengthening with distraction osteogenesis techniques reported in the literature are in growing patients.1-8 For the purposes of this article, an adult patient is defined as a patient who has completed skeletal growth. This includes female patients from the approximate age of 15 years and older and male patients from the approximate age of 17 years.9 Distraction osteogenesis techniques were initially applied to adult patients predominantly with tumorrelated segmental defects of the mandible. Reconstruction of these segmental defects were undertaken using transport distraction osteogenesis techniques with good success.10,11 However, distraction osteogenesis applications continue to expand and adult patients with severe mandibular retrognathia have undergone mandibular lengthening with distraction osteogenesis.4,12,13