Reconstruction of the Mandibular Condyle Using Transport Distraction Osteogenesis

Abstract

Transport distraction osteogenesis was used to reconstruct the articulation of the temporomandibular joint in two patients. Patient 1 underwent a gap arthroplasty for release of a bony ankylosis. Patient 2 had degenerative joint disease after tumor resection. Both patients had painful, limited mouth opening and facial asymmetry as a result of condylar shortening. A reverse-L osteotomy was performed from the sigmoid notch to the posterior border of the mandible. An external transport distraction device was applied, and the segment was advanced superiorly, 1.0 mm per day, until contact was made with the glenoid fossa. After distraction, the bone was found to have remodeled, inducing a new cortical layer on the articular surface. Additionally, a pseudodisk was generated as a result of the transport distraction. The two patients tolerated the procedure well, returning to pain-free normal mouth opening and being able to masticate regular diets.