Supraperiosteal Transport Distraction Osteogenesis for Reconstructing a Segmental Defect of the Mandible

Distraction osteogenesis using the maximal osteogenic potential of the periosteum is introduced and demonstrated in 2 clinical cases. This technique includes minimizing cuts to and reflection of the periosteum on a transport segment; repositioning and suturing the cut periosteum to cover an osteotomy line, which becomes the distraction gap; and fixing an internal distraction device supraperiosteally. The cases involve reconstruction of a segmental defect of the mandible due to a recurrent ameloblastoma. A 51 + 58-mm posterior body and ramus and a 41 + 33-mm anterior body are reconstructed through 2-step and bilateral distraction osteogenesis, respectively. These cases proved the feasibility of the concept of the supraperiosteal transport distraction osteogenesis.