Mandibular symphyseal distraction osteogenesis: 20 years of experience treating transverse deficiencies with an internal hybrid device. Issue 4 (April 2019)

• Record Type: Journal Article
• Authors: Rougier, Guillaume; Diner, Patrick Antoine; Rachwalski, Martin; Galliani, Eva; Tomat, Catherine; Picard, Arnaud; Kadlub, Natacha
• Is Part Of: Journal of cranio-maxillofacial surgery. Volume 47:Issue 4(2019)
• Page Start: 586
• Page End: 591
• Publication Date: 2019-04
• Subjects: Mandibular symphyseal distraction osteogenesis -- Hybrid device -- Mandibular transverse hypoplasia -- Dental crowding -- Tooth-jaw discrepancy; Skull -- Surgery -- Periodicals; Maxilla -- Surgery -- Periodicals; Face -- Surgery -- Periodicals; Surgery, Plastic -- Periodicals; Maxilla -- surgery -- Periodicals; Face -- surgery -- Periodicals; Skull -- surgery -- Periodicals; Oral Surgical Procedures -- Periodicals; Reconstructive Surgical Procedures -- Periodicals; Surgery, Plastic -- Periodicals; Surgery, Oral -- Periodicals; Electronic journals; 617.514
• DOI: 10.1016/j.jcms.2019.01.001
• Languages: English
• ISSNs: 1010-5182

Abstract

Abstract: Introduction: 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. Materials and 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. Results: 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. Conclusion: 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.