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Official Journal of the Italian Society of Maxillofacial Surgery
Aredia F. 1, Reale G. 1, Sesenna E. 2,3
1 Operating Unit of ENT, Umberto I Hospital, Siracusa, Italy
2 Department of Head and Neck Surgery, Parma Hospital, Parma, Italy
3 Division of Maxillofacial Surgery, Parma Hospital Parma, Italy
The reconstruction of important skeletal segments, together with that of the soft parts, often requires the use of complex interventions of reconstructive microvascular surgery. An alternative to the complexity of this approach consists in the method according to which a gradual bony distraction is necessary, known with the term of osteogenetic distraction. In this paper we describe the case of a patient that, following a facial ballistic trauma, presents a bony gap of around 5 cm on the left side of the mandible and the loss of part of the soft tissues around. Given the precarious general conditions of the patient (chronic obstructive pulmonary disease; hepatitis chronic type C), procedures of high surgical impact were excluded (microvascular reconstruction). Therefore, we decided to adopt a less invasive reconstructive technique thanks to the use of an intraoral distractor. This allows bony transfer by means of two different vectors and the simultaneous distraction of the adjacent soft tissues. The case has been completed with the prosthetic dental implantpositioned in the new formed bone.