Bone molding for post-distraction mandibular open-bite closure

Distraction osteogenesis has evolved as a mainstream surgical technique for lengthening and augmentation of the hypoplastic mandible. However, one of the unfavorable results of mandibular distraction is development of postdistraction open-bite and malocclusion. The latter needs immediate or secondary management with the help of guiding elastic traction, intermaxillary fixation, vector re-alignment or re-osteotomies of ossified regenerate to close the lower jaw.

The purpose of this paper is to demonstrate the bone molding technique for open-bite closure and treatment results of eight patients managed with bilateral extraoral mandibular distractors for mandibular micrognathia and retrognathia. According to the research protocol, the mandibles were assessed serially by cephalograms. The study demonstrates that the post-distraction anterior mandibular open-bite can be successfully closed by molding the regenerate without producing fibrous union. Furthermore, the bony regenerate is sufficiently malleable before consolidation to undergo either acute or gradual angular molding without disturbing osteogenic potential. The ability to mold the regenerate without the fear of creating a fibrous union or destroying bony potential provides the surgeon the capability to optimize the dental occlusion and mandibular form as part of the distraction treatment process.

Conflict of interest: None declared.

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Jan 27, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on Bone molding for post-distraction mandibular open-bite closure
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