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Combined maxillary and mandibular distraction osteogenesis.

F Molina1

  • 1Department of Plastic Surgery, General Hospital Dr Manuel Gea Gonzalez, Mexico City, Mexico.

Seminars in Orthodontics
|June 18, 1999
PubMed
Summary

Gradual mandibular elongation corrects facial asymmetry in hemifacial microsomia. A modified technique in adults preserves occlusion, avoiding complex orthodontic treatment and achieving aesthetic results.

Area of Science:

  • Orthognathic Surgery
  • Craniofacial Surgery
  • Orthodontics

Background:

  • Hemifacial microsomia causes facial asymmetry, often requiring mandibular elongation.
  • Traditional mandibular distraction in adults can severely alter dental occlusion, necessitating complex orthodontic correction.
  • Preserving occlusion during mandibular lengthening is crucial for treatment success.

Purpose of the Study:

  • To evaluate a modified mandibular distraction technique in adult hemifacial microsomia patients.
  • To assess the ability of the technique to correct facial asymmetry while maintaining pre-existing occlusion.
  • To avoid the need for extensive postoperative orthodontic treatment.

Main Methods:

  • Simultaneous incomplete Le Fort I osteotomy and mandibular corticotomy.

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  • Initiation of mandibular distraction on the fifth postoperative day with intermaxillary fixation.
  • Gradual distraction to achieve mandibular elongation and correct facial asymmetry.

    • Main Results:

    • The modified technique successfully corrected facial asymmetry in adult patients.
    • Pre-existing stable occlusion was preserved throughout the distraction process.
    • Maxillary and mandibular occlusal planes became horizontal post-distraction, indicating successful correction.

    Conclusions:

    • Simultaneous incomplete Le Fort I osteotomy with mandibular distraction is an effective method for correcting facial asymmetry in adult hemifacial microsomia.
    • This approach preserves stable occlusion, simplifying treatment and avoiding prolonged orthodontic intervention.
    • The technique offers favorable aesthetic outcomes and improved occlusal stability.