Mandibular midline distraction: A systematic review

Mandibular midline distraction using a tooth-borne device and a minimally invasive surgical procedure

“…In a systematic review, de Gijt et al 7 clearly described a higher incidence of irritation and gingivitis in bone-borne devices compared to dental-borne distractors. A possible downside to the use of a tooth-borne distractor might be the less proportionate vertical bony expansion.…”

“…8 Overall, the results in the literature suggest a more proportionate vertical expansion created by bone-borne distractors. 1,8,9 However, de Gijt et al 7 stated that most articles were of low statistical power and controversies remain.…”

Mandibular Midline Distraction Osteogenesis with a Bone-borne, Tooth-borne or Hybrid Distraction Appliance: a Systematic Revieww

“…Transverse mandibular discrepancy is characterized by unilateral or bilateral cross-bite, a tapered mandibular arch, crowded misaligned anterior teeth and a narrow inter-canine width [ 1-3 ]. Minor transverse mandibular discrepancies are generally corrected by orthodontic dental compensation, dental extraction, dental arch expansion or inter-approximal tooth stripping, whereas severe mandibular transverse discrepancies necessitates surgical intervention due to an early fusion of the symphysis and lack of a mandibular midsagittal suture [ 1 , 3 , 4 ]. Transverse mandibular widening following a midline osteotomy and lateral rotation of the two hemi-mandible segments with an interpositional grafting material is a safe and predictable treatment modality for correction of moderate transverse mandibular discrepancies [ 5 ].…”

“…Transverse mandibular widening following a midline osteotomy and lateral rotation of the two hemi-mandible segments with an interpositional grafting material is a safe and predictable treatment modality for correction of moderate transverse mandibular discrepancies [ 5 ]. However, this surgical intervention is rarely used in patients with severe mandibular transverse discrepancies due to an increased risk of periodontal problems and relapse [ 1 , 2 , 6 ].…”

“…Mandibular midline distraction osteogenesis (MMDO) is a surgical technique to widen the mandible by incremental traction and gradually separating the mandibular symphysis in patients with severe mandibular transverse discrepancies [ 1 , 2 ]. MMDO was introduced by Rosenthal in 1951 [ 7 ] and modified by Guerrero et al [ 8 ] in the 1990s.…”