Evaluation of craniofacial effect for mandibular widening by distraction osteogenesis

Aim: The purpose of this prospective study was to evaluate the craniofacial effects for mandibular widening by midline distraction osteogenesis with using tooth borne distraction device. Method: The sample comprised of 20 (8 males, 12 females) patients with skeletal Class I and class II. The mean age in this study was 15,86 ± 2,17 years, ranging from 13,1 to 21,5 years. All patients had moderate and severe mandibular anterior crowding, V shaped arch form and maxillo-mandibular transverse deficiency. A custom made intraoral tooth-borne distraction device was used for distraction. During consolidation period, rapid maxillary expansion was also completed in all of the patients. The patient's records were obtained at the beginning of treatment, at the end of distraction and consolidation periods (165,85 ± 10,42 days after surgery). For statistical analysis, paired t test and Wilcoxon signed-rank test were used. Results: When postero-anterior radiographs were analyzed bicondylar, bimolar, upper and lower implants widths statistically increased and bigonial widths decareased (p<0.05). When 3 dimensional photos analyzed the mouth width , nasal width and anterior height showed a significant increase (p<0.05). Model measurements showed that widening effect gradually decreased from the mandibular canines to the second molars. Conclusions: The short term results of this study would shows that mandibular midline distraction osteogenesis procedure provides an efficient non-extraction treatment alternative for mandibular dental crowding, by increasing the mandibular skeletal and dental arch widths.