Mandibular widening by intraoral distraction osteogenesis

C. A. Guerrero, W. H. Bell, G. I. Contasti, A. M. Rodriguez

Research output: Contribution to journalArticle

144 Citations (Scopus)

Abstract

Transverse mandibular deficiency with crowding of the mandibular anterior teeth is frequently present in patients with Class I and II malocclusions. The hallmarks of treatment by compensating orthodontics, functional appliances or orthopaedic devices are instability, compromised periodontium and compromised facial aesthetics. A new surgical technique has been developed to widen the mandible. The method is based upon gradual osteodistraction following vertical interdental symphyseal osteotomy. Ten patients with transverse mandibular deficiency and significant dental crowding were treated by symphyseal distraction and subsequent non-extraction decompensating orthodontic treatment. Either an intraoral tooth-borne Hyrax appliance or a new custom-made bone-borne osteodistractor was used to gradually widen the mandible. The surgical procedures were accomplished under local anaesthesia and intravenous sedation in an ambulatory surgical setting using an individualized distraction protocol. The appliances were activated 7 days after symphyseal osteotomies, once each day at a rate of 1 mm per day and stabilized for 30-60 days after distraction. After the segments mere distracted, non-extraction orthodontic alignment of the mandibular anterior teeth was accomplished. The symphyseal distraction gaps were bridged by new bony regenerate. Distraction osteogenesis provided an efficient surgical alternative to orthognathic surgery for widening the mandible and treatment of transverse mandibular deficiency without extraction of teeth.

Original languageEnglish (US)
Pages (from-to)383-392
Number of pages10
JournalBritish Journal of Oral and Maxillofacial Surgery
Volume35
Issue number6
DOIs
StatePublished - Dec 1997
Externally publishedYes

Fingerprint

Distraction Osteogenesis
Mandible
Tooth
Malocclusion
Osteotomy
Orthodontics
Hyraxes
Functional Orthodontic Appliances
Orthognathic Surgery
Periodontium
Tooth Extraction
Crowding
Local Anesthesia
Esthetics
Orthopedics
Therapeutics
Bone and Bones
Equipment and Supplies

ASJC Scopus subject areas

  • Dentistry(all)
  • Otorhinolaryngology
  • Surgery

Cite this

Mandibular widening by intraoral distraction osteogenesis. / Guerrero, C. A.; Bell, W. H.; Contasti, G. I.; Rodriguez, A. M.

In: British Journal of Oral and Maxillofacial Surgery, Vol. 35, No. 6, 12.1997, p. 383-392.

Research output: Contribution to journalArticle

Guerrero, C. A. ; Bell, W. H. ; Contasti, G. I. ; Rodriguez, A. M. / Mandibular widening by intraoral distraction osteogenesis. In: British Journal of Oral and Maxillofacial Surgery. 1997 ; Vol. 35, No. 6. pp. 383-392.
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