[Personalized control of distraction rate in mandibular distraction osteogenesis: influence of mechanical and physical factors on bone regenerate maturation].

Mandibular distraction osteogenesis (DO) is a widely used surgical technique for bone lengthening based on the gradual separation of osteotomized bone segments with subsequent formation of a regenerate. The standard distraction rate is 1 mm per day; however, clinical observations reveal individual variations in regenerate mineralization rates, challenging the necessity of a uniform protocol. In recent years, increasing attention has been given to the personalized adjustment of distraction rates to optimize treatment duration and enhance bone quality. For this review, we analyzed 127 publications indexed in PubMed, as well as data from Scopus, Web of Science, and Google Scholar over the past 10 years. The review focuses on studies evaluating the effects of mechanical factors-such as distraction rate and regimen-on regenerate formation, as well as the efficacy of physiotherapeutic methods for stimulating osteogenesis, including low-intensity pulsed ultrasound (LIPUS), low-level laser therapy (LLLT), pulsed electromagnetic field therapy (PEMF), electrical stimulation, and hyperbaric oxygen therapy (HBOT). The development of automated distractors with feedback systems may represent the next step in the evolution of this technique, providing dynamic control of distraction based on objective data.