Background: The mandibular internal curvilinear distractor design produces a curvilinear vector to provide the ideal three-dimensional curvilinear movements compared to the limited straight unidirectional predecessor devices. Objectives: The aim of this study is 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), ages ranging from 5 to 55 years, who underwent mandibular distraction during the period of 12/1999 to 08/2007 at Lucile Packard Children's Hospital in Stanford, California, were included. For pre-operative, postoperative and follow-up (at least 2 years post distraction), panoramic and lateral cephalometric x-rays 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 8-9 mm and 6-8 mm in the panoramic and cephalometric x-rays, respectively, whereas the vertical change of the mandibular ramus achieved was 10-12 mm and 10-11 mm, respectively. The curvilinear distraction effect on the mandible was found to be significantly stable when comparing the long term follow-up measurements to the postoperative data revealed in the panoramic and lateral cephlometric x-rays for the two dimensions. Conclusion: The internal curvilinear device is an effective tool that obtains a stable mandibular distraction resulting in the correction of craniofacial deformities.
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