Distraction Osteogenesis Plus Permanent Rigid Fixation for Mandibular Deformities in Nongrowing Patients: A Comparative Study.

Distraction osteogenesis (DO) is a commonly used intervention of mandibular deformities. However, relapse of the newly constructed mandible is a significant concern. The present comparative study aimed to investigate use of rigid fixation in addition to DO in management of mandibular deformities. The present study included 20 patients with mandibular deformities indicated for DO. The study comprised 10 patients who agreed to perform rigid fixation (DO + RF) and other 10 patients who refused to perform the additional procedure (DO). All patients were subjected to standard mandibular DO. In patients subjected to additional RF with plate and screws, on the last day of distraction, the distractor is removed in the theatre under general anesthesia. Then by an intraoral incision on the previous scar, the distracted part is explored and the plate is applied in the lower part of the mandible to avoid destruction of the teeth roots. All patients are subjected to close observation and radiological evaluation for the appearance of any complication, signs of relapse at the intervals of 1 week and 6 months and 1 year. At the end of follow-up, 2 patients in the DO + RF group relapsed while all patients in the DO only group relapsed (P < 0.001). The relapsed distance was significantly greater in the DO group [(median (range): 0.3 (0.1-1.3) versus 0.0 (0.0-0.2), P ≤ 0.001]. DO + RF provided significantly lower rate and distance of relapse in nongrowing patients with mandibular deformities.