Unilateral Brodie bite treated with distraction osteogenesis

Advantages of symphyseal distraction in the treatment of Brodie’s Syndrome

“…They noticed that the achieved expansion takes place not only in the alveolar bone, but also in the basal bone and surrounding soft tissues. In addition, they observed that the expansion created by symphyseal distraction was not proportionate, namely the expansion was greater in the canine areas than in the molar areas 7,19,23 . Because of this, due to the transverse and anterior-posterior growth achieved, there was an increase in the length of the arch and a change in its shape, going from a ''V'' to a ''U'' 7,9,11 .…”

“…Moreover, all the approaches to increase arch length and the mandibular intercanine width are often subject to relapse, as stipulated by Profitt 27 . ''Expansion'' thus created is not only very unstable, but it also compromises the esthetics of the smile by modifying the black triangles of the buccal corridors 7,4,14,19 .…”

“…The last option could damage the periodontium, particularly if there is a vestibuloversion of the lower anterior teeth, because it forces the teeth out of their alveolar bone 14 . Using intermaxillary elastics to create a vestibuloversion of the mandibular molars and a linguoversion of the maxillary molars also has a role in our therapeutic arsenal 19 . However, this leads to a non-physiologic interdental angulation.…”

“…Several types of symphyseal distractors are on the market: distractors with dental supports, distractors with osseous supports and hybrid distractors, namely osseous and dental supports at the same time 19 . The dental distractor is usually attached to the lingual surface of the teeth and is the source of discomfort and hygiene problems.…”

“…1) 16 . Patients suffering from this syndrome have a Class I or Class II occlusion with either uni-or bilateral maxillary complete buccal crossbite 19 . Since there are no posterior occlusal contacts to be found, the premolars and maxillary molars are over-erupted and completely hide their antagonists (Figs.…”