Outcome of mandibular symphyseal distraction osteogenesis with bone-borne devices.
OBJECTIVE
Mandibular symphyseal distraction osteogenesis (DO) is an alternative to the orthodontic treatment to resolve mandibular anterior width deficiencies or dental crowding. Different types of devices (tooth-borne, bone-borne, and hybrid device) have been used until now. The aim of this clinical study was to report our results with bone-borne device and compare them with previous studies' data to improve our symphyseal distraction protocol and future results.


METHODS
Fourteen patients were treated with symphyseal DO during a 10-year period. Two types of bone-borne distractors have been used. We evaluated morbidity and stability in the short- and long-term (from 12 to 24 months) follow-up, with clinical and radiological examinations.


RESULTS
Appropriate symmetrical distraction of both basal and alveolar bone was obtained for all the patients, but correction of the discrepancy failed in 1 case. Mucosa irritation was the main problem. None of the patients presented with local infection. One temporomandibular joint dysfunction occurred during the distraction period, and 1 patient with preoperative temporomandibular joint dysfunction had his symptoms resolved in the long-term follow-up. In 1 case, a root exposure occurred during osteotomy, resulting in an osteogenesis delay.


CONCLUSIONS
Considering the previous data of the literature and our clinical experience, mandibular symphyseal distraction is a safe alternative to orthodontic and previous surgical treatments, with low morbidity and stable long-term results. Bone-borne device is expected to assert stable results in the long term but with higher morbidity, compared with tooth-borne device. Both surgical techniques and devices have to improve, to assess the superiority of mandibular symphyseal DO to incisor-crowding treatment.
Raoul
Gwenael
G
Oral and Maxillofacial Department, Roger Salengro University Hospital, Lille, France.
Wojcik
Thomas
T
Ferri
Joel
J
D000293:Adolescent; D000328:Adult; D000539:Alveolar Process / Q000601:surgery; D004867:Equipment Design; D005145:Face / Q000002:abnormalities; D005260:Female; D005500:Follow-Up Studies; D005891:Gingivitis / Q000209:etiology; D006801:Humans; D006987:Hypesthesia / Q000209:etiology; D008137:Longitudinal Studies; D008297:Male; D008310:Malocclusion / Q000628:therapy; D008334:Mandible / Q000601:surgery*; D008342:Mandibulofacial Dysostosis / Q000601:surgery; D019857:Osteogenesis, Distraction / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D010027:Osteotomy / Q000295:instrumentation / Q000379:methods; D010155:Palatal Expansion Technique; D011183:Postoperative Complications; D012189:Retrospective Studies; D013529:Surgical Wound Dehiscence / Q000209:etiology; D013706:Temporomandibular Joint Dysfunction Syndrome / Q000209:etiology; D014087:Tooth Movement Techniques / Q000295:instrumentation / Q000379:methods; D014092:Tooth Root / Q000473:pathology; D016896:Treatment Outcome; D055815:Young Adult