Mandibular Osteodistraction for Correction of Deep Bite Class II Malocclusion in a Horse

Abstract

Distraction osteogenesis has the advantage of progressive elongation of the mandible, allowing concurrent bone remodeling and soft tissue adaptation. Severe mandibular incisor malocclusion in horses outside the maximal growth phase can be corrected using this technique.

Treatment of class 2 malocclusion by corrective osteotomy using two short locking compression plates

“…The basis of the success of this technique is thought to be the site of the osteotomy and the subsequent degree of stability that can be obtained by the relatively short LCPs, which were much smaller than the implants used in earlier studies using osteotomy . Symphyseal osteotomy as carried out in our study divides the mandible in only two segments, a rostral ‘incisor’ and a caudal ‘cheek teeth’ segment.…”

“…Verwilghen et al . reported successful gradual mandibular osteo‐distraction in a severe overbite case using an IMEX™ semi‐circular external fixator system . In another study, a type 1 external fixator was used effectively but with serious morbidity in seven horses .…”

Mandibular corrective osteotomy using novel locking compression plate 3.5/4.5/5.0 mm metaphyseal plates

“…Osteotomy of both mandibles as we describe will result in section of the mental nerve within the mandibular canal and desensitization and devitalization of the canine and mandible incisors. In 2 other reports of surgical correction of mandibular brachygnathia, the mandible was sectioned similarly but no complications related to devitalization and/or desensitization of incisor teeth were reported. Verwilghen et al describe full return of lower lip sensation after 3 months .…”

“…In 2 other reports of surgical correction of mandibular brachygnathia, the mandible was sectioned similarly but no complications related to devitalization and/or desensitization of incisor teeth were reported. Verwilghen et al describe full return of lower lip sensation after 3 months . We are unaware of long‐term studies assessing restoration of sensitivity and vitality of incisor teeth in horses.…”

“…Successful mandibular osteodistraction has been reported in a severe case of mandibular brachygnathia by Verwilghen et al by using an IMEX™ circular external fixator system . Seven horses were treated effectively with corrective osteotomy and a type I external fixator system ; however, postoperative morbidity was high because the fixation was unstable, leading to prolonged postoperative pain, perforation of the oral mucosa, infection at the osteotomy site, and pin tract infection.…”