J Korean Assoc Maxillofac Plast Reconstr Surg.  2007 May;29(3):217-226.

Mandibular advancement with distraction osteogenesis for adult class II malocclusion patient with condylar resorption

• Paeng JY
• Lee SW
• Lee JY
• Myoung H
• Hwang SJ
• Seo BM
• Choi JY
• Lee JH
• Choung PH
• Kim MJ

Abstract

PURPOSE: Distraction osteogenesis is considered to take favorable effect on the TMJ and be beneficial to prevent the relapse after the mandibular advancement of Class II malocclusion patient. This is the report with literature review on the mandibular advancement in the patients showing preoperative condylar resorption and who need larger amount of advancement.
PATIENTS AND METHOD
Distraction osteogenesis using intraoral device was performed for three mandibular hypoplasia patients (one male and two females). All patients were adult over 18 years old. The patients showed condylar bony resorption preoperatively. The distraction was performed intraorally with modified SSRO. After 7 days of latency period, activation was performed at the rate of 1.0 mm/day with twice turn. The devices were removed after 4-8 month consolidation period.
RESULTS
Total advancement of mandible was average 13 mm. One patient showed openbite immediately after removal of distraction device. It took long time to guide the openbite with elastics. The comparison between cephalometries immediately after device removal and postoperative six month revealed average 3.4 mm relapse. This means that mandibular advancement with distraction osteogenesis needs overcorrection and elastic rehabilitation even after enough consolidation periods.
CONCLUSION
Larger amount of mandibular advancement could be achieved with distraction osteogenesis in severe mandibular hypoplasia with condylar resorption. However, some relapse was found during the follow-up period and the over correction is considered to be needed. The effect of distraction osteogenesis seems to be investigated with long-term follow-up.

Keyword

Distraction osteogenesis; Condyle resorption; Mandibular retrognathism

MeSH Terms

Adolescent
Adult*
Device Removal
Follow-Up Studies
Humans
Latency Period (Psychology)
Male
Malocclusion*
Mandible
Mandibular Advancement*
Open Bite
Osteogenesis, Distraction*
Recurrence
Rehabilitation
Temporomandibular Joint