Segmental distraction osteogenesis of the anterior alveolar process.
OBJECTIVE
This article describes a nonextraction therapy for patients with anterior tooth crowding in the mandible or with an unfavorable relation between the anterior dentoalveolar area and the skeletal base. The method involves the gradual repositioning of the dentate segment by use of distraction osteogenesis.


METHODS
The method was applied in 25 patients. Indications comprised skeletal Class II patients with crowding, Class I patients with crowding, and Class III patients requiring decompensation before orthognathic surgery. A special hinge-joint bone plate was developed to allow the rotation of the anterior bone segment into the desired position. The gradual repositioning was achieved with orthodontic appliances.


RESULTS
The procedure was successful in all patients. The typical advancement at the incisal edge was 2 to 5 mm.


CONCLUSIONS
This method represents a new approach for nonextraction therapy in the mandible. It requires no soft or hard tissue grafting and results in favorable tissue conditions at the distraction site.
Triaca
A
A
Center for Maxillofacial Surgery, Pyramide Clinic, Zurich, Switzerland. triaca@access.ch
Antonini
M
M
Minoretti
R
R
Merz
B R
BR
D000539:Alveolar Process / Q000601:surgery*; D001860:Bone Plates; D004867:Equipment Design; D005500:Follow-Up Studies; D006801:Humans; D008310:Malocclusion / Q000601:surgery*; D008311:Malocclusion, Angle Class I / Q000601:surgery; D008312:Malocclusion, Angle Class II / Q000601:surgery; D008313:Malocclusion, Angle Class III / Q000601:surgery; D008334:Mandible / Q000601:surgery*; D009967:Orthodontic Appliances; D019857:Osteogenesis, Distraction / Q000295:instrumentation / Q000379:methods; D010027:Osteotomy / Q000379:methods; D012399:Rotation; D016896:Treatment Outcome