To lengthen the child's mandibular ramus, we use, since 1977, an autologous osteochondral rib graft fixed to the posterior margin of the ramus. Experimental studies show that this graft has a growth potential, the osteochondral junction responds to the biomechanical forces in a similar way to the mandibular condyle. Surgical treatment allows an immediate restitution of the morphology, normal masticatory function and good buccal opening. The interposition of cartilage prevents recurrence. The growth potential of the graft due to osteochondral junction activity, allows surgery to be performed in childhood, without requiring a further surgical operation several years later. This constitutes an optimistic prospect for the future and the good results obtained with 8 patients are analyzed.
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