Midface distraction osteogenesis using a modified external device and 3D virtual simulation: technical note

Introduction/Background: Distraction osteogenesis (DO) with an external distraction device such as the rigid external distraction frame has become an established method for treating midface hypoplasia in faciocraniosynostosis. It allows for greater advancement of the midface in comparison with traditional Le Fort III osteotomies, associated or not with fronto-orbital osteotomies (Le Fort IV). However, the forward movement of the bone segments may not always be performed obeying an ideal distraction vector, resulting in asymmetries, anterior open bite, and loosening of screws. In addition, the cost of the distraction devices is significant and may preclude their routine use in developing countries. Method: We present an alternative device and method for craniofacial advancement in a clinical case of Crouzon’s syndrome. Results: A 3D virtual simulation of the distraction vector and a modified external device were used in the current case. Conclusion: The alternative external device in this case proved to be safe, effective, and reliable.