[Symphyseal distraction : clinical cases]

The discussion on whether to extract or not is still a source of debate. However, primacy must be given to the diagnosis based on a dental, skeletal, aesthetic and functional assessment. The therapeutic means are intended to achieve the goals resulting from this diagnosis which are the only way to individualize the treatment plan according to the patient. Symphyseal distraction is a surgical procedure intended to increase the mandibular bone base at the symphysis level and then allow an ideal positioning of the mandibular incisor. After explaining the procedure to integrate this intervention in the treatment plan, the author studied in 25 clinical cases the displacement of the mandibular incisor according to the initial crowding and the increase of the distance between the mandibular cuspids before and after bone distraction. Symphyseal distraction is an effective alternative to the treatment of dental crowding to the mandible by helping to restore nasal breathing by its association with maxillary disjunction while respecting of physiology and balance facial.