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Purpose <p>To describe a novel couple guide technique using a skin guide (SG) and bone guide (BG) designed through virtual surgical planning (VSP) to improve the accuracy of pin placement and osteotomy in mandibular distraction osteogenesis (MDO).</p> Methods <p>A technical note describing the workflow for designing and using dual surgical guides is presented. Preoperative computed tomography data were used to perform VSP, including segmentation of bone, soft tissue, and neurovascular structures. Parallel distractor pin trajectories and osteotomy planes were planned virtually. A tuning fork–shaped SG was designed to guide transcutaneous pin entry points, while a BG was fabricated to guide osteotomy and bone-level pin positioning. Both guides were 3D printed and applied intraoperatively in a clinical case of MDO.</p> Results <p>The use of the coupled SG and BG enabled accurate transfer of the virtual plan to the surgical field. The technique facilitated precise and symmetrical pin placement, improved parallelism of distractor pins, and reduced the need for multiple skin punctures. It also aided in avoiding injury to vital structures and optimizing the distraction vector.</p> Conclusion <p>The couple guide technique is a simple and practical adjunct to VSP that enhances the accuracy and predictability of MDO. By improving pin placement and distractor alignment, it may reduce complications and improve surgical outcomes. Despite certain limitations, including added cost and a learning curve, this approach represents a feasible alternative to more complex CAD-CAM systems, particularly in settings seeking cost-effective precision.</p>

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Couple guide for mandibular distraction osteogenesis using multiplanar distractor: a technical note

  • 期刊论文

  • 发表日期：

    2026年6月20日

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  • Ajoy Roychoudhury,
  • Shanmuga Sundaram Devaraj,
  • Poonam Yadav,
  • Sanjeev Lalwani,
  • Kishore

摘要

Purpose

To describe a novel couple guide technique using a skin guide (SG) and bone guide (BG) designed through virtual surgical planning (VSP) to improve the accuracy of pin placement and osteotomy in mandibular distraction osteogenesis (MDO).

Methods

A technical note describing the workflow for designing and using dual surgical guides is presented. Preoperative computed tomography data were used to perform VSP, including segmentation of bone, soft tissue, and neurovascular structures. Parallel distractor pin trajectories and osteotomy planes were planned virtually. A tuning fork–shaped SG was designed to guide transcutaneous pin entry points, while a BG was fabricated to guide osteotomy and bone-level pin positioning. Both guides were 3D printed and applied intraoperatively in a clinical case of MDO.

Results

The use of the coupled SG and BG enabled accurate transfer of the virtual plan to the surgical field. The technique facilitated precise and symmetrical pin placement, improved parallelism of distractor pins, and reduced the need for multiple skin punctures. It also aided in avoiding injury to vital structures and optimizing the distraction vector.

Conclusion

The couple guide technique is a simple and practical adjunct to VSP that enhances the accuracy and predictability of MDO. By improving pin placement and distractor alignment, it may reduce complications and improve surgical outcomes. Despite certain limitations, including added cost and a learning curve, this approach represents a feasible alternative to more complex CAD-CAM systems, particularly in settings seeking cost-effective precision.