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Patient specific cutting guides and distractors decrease operative time in infants undergoing mandibular distraction osteogenesis
Abstract   Open access   Peer reviewed

Patient specific cutting guides and distractors decrease operative time in infants undergoing mandibular distraction osteogenesis

Jeffrey S. Marschall
Journal of cranio-maxillo-facial surgery, Vol.54(Suppl 1), 107581
09/2026
DOI: 10.1016/j.jcms.2026.107581
url
https://doi.org/10.1016/j.jcms.2026.107581View
Published (Version of record) Open Access

Abstract

Objectives: Mandibular distraction osteogenesis (MDO) is a surgical treatment for upper airway obstruction in infants with micrognathia. Recent advances in virtual surgical planning have enabled the use of patient-specific cutting guides and distractors; however, limited objective data exist regarding their effect on operative time. The purpose of this study was to evaluate if the use of patient-specific cutting guides and/or patient-specific mandibular distractors is associated with decreased operative time in infants undergoing MDO. Materials and Methods: A retrospective cohort study was completed in infants treated with MDO at a single tertiary pediatric hospital between 2015 and 2025. Subjects older than 1 year of age or with incomplete data were excluded. A total of 39 subjects met inclusion criteria. Predictor variables included device type (patient-specific cutting guides: yes/no; patient-specific distractors: yes/no; stock distractors: yes/no), age at surgery (days), weight (kg), sex, and presence of a syndromic diagnosis. The primary outcome variable was operative procedure time (minutes). Results: The median age at surgery was 76 days (IQR, 29–135 days), and the median operative time for the cohort was 195 minutes (IQR, 171–243 minutes). Patient-specific cutting guides were used in 22 cases (56%). Use of cutting guides was associated with a significantly shorter operative time compared with cases performed without guides (median 185 vs 213 minutes; P = .037). When either patient-specific cutting guides or patient-specific distractors were used, operative time was further reduced compared with stock devices alone (median 184 vs 232 minutes; P = .008). The multivariable linear regression analysis revealed patient-specific cutting guide use was the only independent predictor of reduced operative time (β = −39 minutes; 95% confidence interval, −74 to −3.9; P = .030). Conclusion: Use of patient-specific cutting guides during MDO is associated with a clinically meaningful reduction in operative time. These findings support the routine incorporation of virtual surgical planning, patient-specific hardware to improve operative efficiency in infants undergoing MDO.

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