Automated continuous mandibular distraction osteogenesis: review of the literature.

PURPOSE Current devices for mandibular distraction osteogenesis (DO) are complex and require significant patient or family skill during active distraction. Successful development of an automated, continuous distraction device would eliminate the need for patient participation in this process. The purpose of this study was to comprehensively review devices currently in development for continuous DO and to identify and evaluate the achieved successes and remaining problems. MATERIALS AND METHODS A PubMed search of the English language literature in October 2008 using the keywords automatic or automated or continuous or hydraulic or motor or magnetic or spring and distraction osteogenesis was performed. The search included all technical notes, animal studies, and human studies describing the use of any automated continuous distraction device for the mandible. Excluded were studies using distraction devices employing hydraulics, motors, or springs that did not distract automatically and continuously and devices used for bones other than the mandible. RESULTS The search returned 97 matches. Of these, 12 articles were selected as relevant to this review based on the inclusion and exclusion criteria detailed above. Eight distinct devices for automated, continuous DO were described in these reports and evaluated in this review. These included motor-driven, spring-mediated, and hydraulically powered distractors. CONCLUSIONS The abundance of research currently underway to develop a continuous distractor highlights the clinical demand for, and usefulness, of such a device. Despite many advances and promising results, significant problems remain to be overcome before any of these devices gain widespread clinical acceptance.