title: Distraction osteogenesis of ankylosed front teeth with subsequent orthodontic fine adjustment.
abstract: OBJECTIVE
  Conventional therapeutic approaches to correct ankylosed anterior teeth in infraposition require compromises involving esthetics and function. The combined approach of distraction and early orthodontic fine adjustment, not yet established as a routine, promises better results concerning the bone conditions and gingival development.
  
  
  METHODS
  Both female patients had suffered a trauma to the front teeth during early mixed dentition resulting in ankylosed central incisors in infraposition. At the ages of 14 years and 2 months and 15 years and 2 months, respectively, we carried out segment distraction by means of a bone-supported internal distractor followed by orthodontic fine adjustment after having shortened the consolidation phase. Both ankylosed front teeth could be successfully aligned, leading to an increase in bone and harmonization of the gingival margin in the dental arch. At ten and 14 months after the conclusion of treatment, we observed only few deviations in the dental situation compared to posttherapeutic findings.
  
  
  CONCLUSIONS
  From a functional and esthetic point of view, therapy involving combined orthodontics and surgery is superior to conventional therapy. Orthodontic fine adjustment should be considered as a continuation of the distraction procedure.
authors.affiliation: Department of Orthodontics, Center of Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. huck@uke.uni-hamburg.de
authors.forename: Lothar
authors.initials: L
authors.lastname: Huck
authors.forename: Heike
authors.initials: H
authors.lastname: Korbmacher
authors.forename: Karsten
authors.initials: K
authors.lastname: Niemeyer
authors.forename: Bärbel
authors.initials: B
authors.lastname: Kahl-Nieke
mesh_terms: D002648:Child; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D009967:Orthodontic Appliances; D019857:Osteogenesis, Distraction / Q000295:instrumentation* / Q000379:methods*; D020254:Tooth Ankylosis / Q000175:diagnosis* / Q000628:therapy*; D016896:Treatment Outcome