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Versatility of Transport Distraction Osteogenesis for Reconstruction of Lateral Mandibular Ablative Defects

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Abstract

Introduction

The reconstitution of form and function after maxillofacial tumor resection or traumatic bony defects is a challenge when considering reconstructive options. The reconstructive options will depend upon whether the tissues to be replaced included bone alone or both bone and soft tissue (composite resection).

Methodology

This study was carried out on nine patients who with benign tumors or cysts of the mandible that required segmental resection. Mandibular reconstruction using mandibular transport distraction osteogenesis was performed for all the cases. Depending on whether the condyle was spared or sacrificed, the type of mandibular transport distractor either fixed on the remnant condyle-ramus unit or had a condylar component replacing the resected condyles. Depending on the location of the defect, transport distraction was carried our anterior to posterior or posterior to anterior.

Results

A total of nine cases of benign mandibular pathologies were operated. Segmental resection with condylar preservation was carried out in seven cases, segmental resection with condylar resection was carried out in two cases. In cases with condylar resection, the reconstruction plate of the distractor device had a condylar component. Anterior to posterior transport distraction was carried out in seven cases, and posterior to anterior transport distraction carried out in two cases. The amount of distracted bone ranged from 38 to 46 mm.

Conclusion

Mandibular transport distraction osteogenesis offers a modality of reconstruction where the patient’s native host bone is osteotomized and gradually distracted to induce the formation of regenerated osseous structure and soft tissue. Being cost-effective, not requiring a steep learning curve/long operative time, and not technically demanding as vascularized bone grafts/flaps, it is feasible in the Indian setup as a practical reconstructive option for benign jaw tumors.

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Funding

No funding was received for this study.

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Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, Meenakshi Ammal Dental College and Hospital, Meenakshi Academy of Higher Education and Research (Deemed to Be University), Alapakkam Main Road, Maduravoyal, Chennai, Tamil Nadu, 600095, India

    R. S. Neelakandan, Thomas Zachariah, Pradeep Devadoss & Dhayasankar Prabhu Shankar

  2. Department of Oral and Maxillofacial Surgery, Anil Neerukonda Institute of Dental Sciences, Sangivalasa, Bheemunipatnam Mandal, Visakhapatnam District, Andhra Pradesh, 531162, India

    Phani Kumar Kuchimanchi

Authors
  1. R. S. Neelakandan
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  2. Thomas Zachariah
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  3. Phani Kumar Kuchimanchi
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  4. Pradeep Devadoss
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  5. Dhayasankar Prabhu Shankar
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Contributions

All authors contributed to the study conception and design. Material preparation, analysis and interpretation of data was performed by TZ. PKK, PD and DPS helped in the acquisition of data. RSN revised it critically for important intellectual content and made substantial contributions to the conception and design of the work. All authors commented on previous versions of the manuscript and read and approved the final.

Corresponding author

Correspondence to Thomas Zachariah.

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The authors declare that they have no conflict of interest.

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“All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.”

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Informed consent was obtained from all individual participants included in the study.

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Neelakandan, R.S., Zachariah, T., Kuchimanchi, P.K. et al. Versatility of Transport Distraction Osteogenesis for Reconstruction of Lateral Mandibular Ablative Defects. J. Maxillofac. Oral Surg. 23, 630–638 (2024). https://doi.org/10.1007/s12663-023-01923-6

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  • DOI: https://doi.org/10.1007/s12663-023-01923-6

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