Mandibular symphyseal distraction osteogenesis: 20 years of experience treating transverse deficiencies with an internal hybrid device

Transverse mandibular deficiency has been traditionally managed by orthodontic compensation. However, without resolving the underlying skeletal hypoplasia it leads to high relapse rates. Few studies have reviewed the long-term experience and potential complications of mandibular symphyseal distracti...

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Bibliographic Details
Published in:Journal of cranio-maxillo-facial surgery 2019-04, Vol.47 (4), p.586-591
Main Authors: Rougier, Guillaume, Diner, Patrick Antoine, Rachwalski, Martin, Galliani, Eva, Tomat, Catherine, Picard, Arnaud, Kadlub, Natacha
Format: Article
Language:English
Subjects:
Adolescent
Cephalometry
Child
Child, Preschool
Dental crowding
Dentistry
Follow-Up Studies
Humans
Hybrid device
Life Sciences
Mandible
Mandibular symphyseal distraction osteogenesis
Mandibular transverse hypoplasia
Osteogenesis, Distraction
Retrospective Studies
Tooth
Tooth-jaw discrepancy
Young Adult
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Summary:Transverse mandibular deficiency has been traditionally managed by orthodontic compensation. However, without resolving the underlying skeletal hypoplasia it leads to high relapse rates. Few studies have reviewed the long-term experience and potential complications of mandibular symphyseal distraction osteogenesis (MSDO) as an alternative treatment method. A retrospective review of 20 patients (range: 4–19 years; mean: 11.9 years) treated with a hybrid MSDO device over the period of 1996–2017 was conducted. Epidemiological data, medical and dental history as well as photographic and cephalometric analyses were carried out. Furthermore, pre-operative and long-term post-operative status including dental occlusion and tooth-jaw discrepancies were recorded. The distraction amount ranged from 3 mm to 15 mm (mean: 10 mm) with an average distraction period of 30.9 days. In long-term follow-up (mean: 7.3 years), 14 patients presented a class I and 6 patients presented a class II relationship. Correction of overjet, tooth jaw discrepancy and arch length discrepancy were obtained in 18, 20 and 17 cases respectively. A device malfunction was experienced in 6 patients. Mandibular widening using a hybrid MSDO device can be efficiently and safely performed in a paediatric population. Further studies confirming our results and analysing facial aesthetic outcomes are warranted.
ISSN:1010-5182
1878-4119
DOI:10.1016/j.jcms.2019.01.001