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Distraction osteogenesis helps create new bone by using the natural bone repair process. This technique, applied to the symphysis, affords a new perspective: increasing the mandibular transverse dimension in a stable way due to a simultaneous expansion of the skeletal structure. In this respect, it represents a potential alternative to therapy conventionally implemented to remedy dental crowding and mandibular transverse deficiency. All the same, the technique remains marginal as it is considered to be too invasive and risky. With the exception of the patient's cooperation, the success of mandibular symphyseal distraction osteogenesis (MSDO) relies on three main points: good knowledge of indications, strict compliance with the protocol, and lastly the prevention and management of possible complications. After reviewing these three sections, we will cover a few clinical applications.

A 42-year-old woman had sustained a severe dental trauma with an alveolar fracture after an epileptic attack. A tooth block 31, 32, 33 and 34 was dislocated about 7 mm in buccal direction. Panoramic X-rays and CT-scan disclosed the alveolar fracture without total disjunction of the fragment. An orthodontic appliance was used to reduce the fracture with gentle forces during a 5-month period. Normal function was established and the teeth remained vital.

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