Mandibular Distraction, Orthodontic Considerations

Abstract

Mandibular distraction has been successfully used to correct mandibular hypoplasia in all three dimensions since its introduction in 1989 by McCarthy and NYU colleagues [1]. Patients with craniofacial microsomia, Nager syndrome, Treacher Collins syndrome, Robin sequence, temporomandibular joint ankylosis, posttraumatic growth disturbances, and a variety of other mandibular developmental disturbances have significantly benefited from this technique. As with traditional orthognathic surgery, pre- and post-distraction orthodontic therapy is an integral part of the successful outcome of distraction. The goals of pre- and post-distraction orthodontics therapy include the following: preoperative evaluation of the craniofacial skeletal and dental relationships, preparation of the dentition prior to the placement of a distraction device, collaboration with the surgeon on the placement of the distraction device for the optimal vector of distraction, monitoring of the skeletal changes during the activation phase, molding of the generate during the activation and consolidation phase, the management of post-distraction occlusion for long-term stability, and continued longitudinal follow-up.