Segmental distraction osteogenesis of the anterior mandible for improving facial esthetics. Preliminary results.
OBJECTIVE
To report preliminary results of treatment with gradual repositioning of the anterior mandibular segment using distraction osteogenesis in patients with anterior tooth crowding and/or an unfavorable anteroposterior relationship between the anterior dentoalveolar area and the skeletal base.


METHODS
The following outcome measures were considered: ability of the technique to achieve the desired skeletal jaw position, resolution of the crowding, periodontal condition (recessions and probing pocket depths), temporomandibular joint symptoms, tooth sensitivity, permanent nerve injury, additional complications, and patient satisfaction. Four patients were treated.


RESULTS
All outcome measures indicated that the therapy goal was achieved and the results maintained to date. Periodontal conditions were slightly improved. Two patients were very satisfied; 2 were only partially satisfied with the therapy. In 1 patient the root of the mandibular right first premolar was damaged during the vertical osteotomy procedure and the mandibular right central incisor did not respond to the postoperative sensitivity test. Another patient reported tension at the temporomandibular joint when chewing hard food.


CONCLUSIONS
The preliminary results are encouraging. However, larger trials are needed to acquire sufficient knowledge of the efficacy, predictability, and ideal indications for the mandibular osteodistraction technique.
Merli
Mauro
M
Center for Maxillofacial Surgery, Pyramide Clinic, Zurich, Switzerland. mmerli@rimini.com
Merli
Monica
M
Triaca
Albino
A
Esposito
Marco
M
D000293:Adolescent; D000328:Adult; D003807:Dentin Sensitivity / Q000145:classification; D005260:Female; D005889:Gingival Recession / Q000145:classification; D006801:Humans; D008297:Male; D008310:Malocclusion / Q000601:surgery*; D008312:Malocclusion, Angle Class II / Q000601:surgery; D008313:Malocclusion, Angle Class III / Q000601:surgery; D008334:Mandible / Q000601:surgery*; D019857:Osteogenesis, Distraction / Q000379:methods*; D010292:Paresthesia / Q000145:classification; D017060:Patient Satisfaction; D010514:Periodontal Pocket / Q000145:classification; D011183:Postoperative Complications; D063173:Retrognathia / Q000601:surgery; D013705:Temporomandibular Joint Disorders / Q000145:classification; D016896:Treatment Outcome; D061221:Trigeminal Nerve Injuries