Let's Talk About That Figure 5. KLS-Martin neonatal mandibular distraction device Figure 6. KLS-Martin external midface distractor PKT: At what age is distraction osteogenesis performed? WO: The short answer is any age. Distraction can be performed in infants with small mandibles and airway issues, such as Pierre Robin sequence (Figures 4 and 5) and Treacher Collins syndrome. Distraction osteogenesis can be performed in the midface and mandible of children and teenagers with craniofacial syndromes. In severe cases, distraction osteogenesis can be performed in adults with severe craniofacial deformities. PKT: Are all distraction osteogenesis appliances now internal or are some still external? WO: Distraction osteogenesis is currently done both externally (Figure 6) and internally (Figures 7 and 8). Figure 8. KLS-Martin internal Le Fort III or monobloc distractor Figure 7. KLS-Martin maxillary Le Fort I internal distractor 62 PCSO Bulletin Summer 2023