Distraction Osteogensis

What Is Distraction Osteogenesis?

Transverse mandibular hypoplasia with crowding of the anterior teeth and a V-shape of the mandible is frequently seen in patients with Class I and II malocclusions and Class III patients requiring decompensation before orthognathic surgery.  Traditionally, teeth slicing and teeth extractions with compensating orthodontics, functional appliances, or orthopedic devices have been the first choice of treatment, but have resulted in instability, compromised periodontium, and compromised facial aesthetics.  The surgical technique of widening the symphysial area of the mandible is based upon gradual distraction following vertical interdental symphysial osteotomy and has proven to be successful.

The Rotterdam Midline Distractor is very easily placed and activated.  The procedure is done under general anesthesia.  Via a standard incision in the labial vestibulum, easy access is gained to the bony structure of the symphysial area.  The plates of the distractor are bent and adjusted to the form of the mandible.  The distractor is then placed with six screws.  The retention period of the distractor is approximately three months.  The patient will turn the distractor daily until the recommended width has been achieved.  At the end of the consolidation period, the Rotterdam will be removed.

In sleep apnea cases, which require more transverse width, this procedure is recommended to gain the necessary width followed by surgical expansion of the maxilla.