Mandibular bi-directional distraction osteogenesis: A technique to manage both transverse and sagittal mandibular diameters via a lingual tooth-borne acrylic plate and double-hinge bone anchorage.
J Craniomaxillofac Surg
; 47(10): 1521-1529, 2019 Oct.
Article
em En
| MEDLINE
| ID: mdl-31377072
ABSTRACT
PURPOSE:
Mandibular hypoplasia can develop transversely, sagittally, or in both diameters simultaneously. Current techniques achieve either sagittal or transverse expansion with different surgeries. Here, we present a novel method to obtain transverse and sagittal mandibular distraction in one stage. MATERIALS ANDMETHODS:
The technique consists of a double osteotomy a dento-alveolar osteotomy comprising four or six anterior teeth and a vertical symphysiotomy underneath. The mandibular basal bone is immediately expanded transversely and fixed to the lower symphysis via a miniplate carrying only one screw on each side that functions as a hinge during active distraction. The plate is connected to the anterior dento-alveolar block with a metal wire ligature. A teeth-anchored lingual distraction system can expand transversely at the alveolar bone level and then sagittally with the anterior dento-alveolar segment wired to the lower plate.RESULTS:
Satisfying and stable results were achieved, confirmed by measurements on serial plaster casts.CONCLUSION:
To the best of our knowledge, this is the first proposal for ortho-surgical correction of both transversal and sagittal mandibular hypoplasia via a bi-directional distraction procedure. A combination of bone-hardware anchorage and dental-anchored distraction systems is suggested. Transmucosal hardware emergence and need for a second surgery to remove bone-borne appliances are avoided.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Dente
/
Osteogênese por Distração
/
Má Oclusão
Limite:
Humans
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article