This report presents the treatment of a patient with severe mandibular anterior crowding caused by anterior transverse deficiency of the mandible. The treatment plan called for midsymphyseal distraction osteogenesis. A tooth-supported distractor placed on the lingual aspect of the mandible was used for mandibular widening.

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[Symphyseal bone distraction (part 2): which protocol in 2018? A systematic literature review].

Orthod Fr

September 2018

Faculté d'Odontologie,rue Guillaume Paradin 69372 Lyon cedex 08, France.

Introduction: The aim of this systematic literature review is to propose a clinical protocol in 2018 by comparing therapeutic efficacy and undesirable effects of the technique.

Materials And Methods: Searches were made on Pubmed/Medline and Cochrane for randomized clinical trials and case series involving mandibular symphyseal distraction over the past 20 years with a patient sample greater than or equal to 10.

Results: Of the 92 articles, 25 met the inclusion criteria.

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This report presents the treatment of a patient with severe mandibular anterior crowding caused by anterior transverse deficiency of the mandible. The treatment plan called for midsymphyseal distraction osteogenesis. A tooth-supported distractor placed on the lingual aspect of the mandible was used for mandibular widening.

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Dental crowding is frequently associated with transverse jaw discrepancies, resulting in a less-than-ideal position of the teeth in the basal bone. The classic aproach for correcting bimaxillary crowding are extractions or arch expansion. Rapid maxilla-mandibular expansion was used to treat transverse discrepancies in growing patients, but with aging, the upper and lower jaw bones become increasingly resistant to expansion.

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Objective: To evaluate the biomechanical effect of midsymphyseal distraction osteogenesis with three types of distractors on the mandible and articular disc using a three-dimensional finite element model analysis.

Materials And Methods: A virtual model of the mandible was produced from computed tomography scan images of a healthy 27-year-old man. On the finite element model of the mandible, expansion of the bone-borne, tooth-borne, and hybrid type distractors were simulated with the jaw-closing muscles.

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