Mandibular Lengthening: Multi-Guide™
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Pin Placement and Insertion

• Drill a 1.5 mm pilot hole approximately 10 mm proximal to the planned osteotomy line
  
• Insert the first 2.0 mm threaded half-pin through the same hole of the trocar using the manual pin driver (gray)
  
• Drill a second 1.5 mm pilot hole 4 mm distal to the inserted pin
  
• Insert the second 2.0 mm threaded half-pin using the manual pin driver
  
• Drill the third 1.5 mm pilot hole approximately 6 mm distal to the planned osteotomy line
  
• Insert the third 2.0 mm pin using the manual pin driver
  
• Drill the last hole 4 mm distal to the inserted pin using the manual pin driver
  
• Insert the fourth 2.0 mm pin using the manual pin driver
  
• In patients with a severe ramus deficiency, a small submandibular cutaneous incision (0.5 cm) will facilitate pin placement and osteotomy

FIG. 6.1.2.3. Pin placement in the proximal and distal mandibular segments.