Segmental alveolar distraction: the same or different technique.
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Biomedical subjects
Publications and source records attributed to Y Razdolsky.
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Tooth-borne/hybrid distraction devices offer a new approach for intraoral DO and better control of the distracted bony segments. These appliances also offer a unique characteristic by using the teeth as reference points for obtaining parallelism of the distraction devices to each other and to the vector of distraction in bilateral cases. More studies may be needed for long-term evaluation of the obtained results with intraoral distraction devices as well as biomechanical analysis of stress distribution throughout the mandible after distraction.
PURPOSE: This report describes the application of an intraoral device for treatment of malocclusions characterized by mandibular deficiency and the surgical technique for its placement. PATIENTS AND METHODS: In an office setting, 5 retrognathic patients underwent mandibular lengthening via distraction osteogenesis with an intraoral tooth-borne distraction device. Under local anesthesia and sedation, mandibular corticotomies, mobilization, and placement of the distractors were performed. Preoperative, intradistraction, and postoperative dental casts, photographs, and cephalometric radiographs were used to analyze the results. RESULTS: In 3 of the 5 cases, distraction occurred along the planned vector. The remaining 2 cases showed opening rotations of the mandibular anterior segment along with the advancement. CONCLUSIONS: This study documents that the mandible and the dental arch can be lengthened successfully using this technique.
Occlusal contacts in maximum intercuspation were examined in a sample of 40 patients at the end of active orthodontic treatment and again an average of 21 months later. An increase in the total number of contacts was due to more actual and near contacts on all posterior teeth and more near contacts on anterior teeth. When the results were compared to a previous short term study, continued settling of the occlusion occurred beyond an initial three months of retention. Few contacts changed their location between the occlusal inclined planes and central grooves, suggesting minimal settling of the occlusion in a buccolingual direction.