Using in-house 3D technology for optimal spatial positioning of elongation devices for distraction osteogenesis-a cost-effective alternative.

Introduction: Mandibular distraction osteogenesis is globally accepted as the gold-standard surgical solution for various craniofacial deformities and syndromes. Stock device evolution has advanced into complex designs to achieve the most accurate three-dimensional distraction vector of elongation. Today's cutting-edge solution is patient-specific distractors designed by virtual surgical planning (VSP) to facilitate surgical performance and ensure the most predictable clinical results. However, tailoring patient-specific distractors comes with a significant price tag. Methods: Using VSP technology, we developed an inexpensive stepwise method of precisely directing the distraction vector by adapting off-the-shelf distractors for the individual contour of the patients' mandibles based on the in-house designed and printed cutting guides. Results: The virtual planning sequence and clinical application are described in detail. The final results are assessed by 3D analysis to confirm the method's precision and predictability. Discussion: The final positions of the adapted off-the-shelf distractors were found to match the pre-operative virtual planning precisely, resulting in excellent clinical results. This method can be easily reproduced in similar clinical cases with reduced cost.