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Occlusal Plane Stability After Curvilinear Mandibular Distraction Osteogenesis.

Isabel A Ryan¹, Ashley E Chang, Philip D Tolley

¹Division of Plastic, Reconstructive, and Oral Surgery, Children's Hospital of Philadelphia, Philadelphia, PA.

The Journal of Craniofacial Surgery

|July 21, 2025

Summary

Curvilinear mandibular distraction osteogenesis (MDO) significantly improves mandibular growth and occlusal plane stability in mixed dentition patients. These positive cephalometric changes are maintained for at least 4 years post-surgery.

Keywords:

Curvilinear distraction mandibular distraction osteogenesis occlusal plane treacher collins

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Area of Science:

Craniofacial surgery
Orthodontics
Pediatric dentistry

Background:

Mandibular hypoplasia often requires surgical intervention for correction.
Curvilinear mandibular distraction osteogenesis (MDO) offers simultaneous sagittal and vertical mandibular lengthening.
Long-term stability of occlusal plane changes after MDO in mixed dentition is not well-established.

Purpose of the Study:

To evaluate the stability of occlusal plane changes following curvilinear MDO in pediatric patients with mixed dentition.
To assess cephalometric changes in Sella-nasion-B point angle (SNB), SN-mandibular plane angle (MPA), and SN-occlusal plane angle (OPA).
To compare outcomes between patients with and without postoperative orthodontic treatment.

Main Methods:

Retrospective review of 25 patients undergoing curvilinear MDO (2009-2024).
Cephalometric analysis of preoperative, immediate postoperative, and extended postoperative imaging (mean follow-up: 4 years).
Assessment of SNB, MPA, and OPA angles; comparison of outcomes with and without orthodontics.

Main Results:

Significant improvements in SNB (69° to 76°), MPA (57° to 48°), and OPA (30° to 23°) were observed post-MDO (P<0.001).
These cephalometric improvements remained relatively stable at the 4-year follow-up.
Occlusal plane angle relapse was similar between patients with and without postoperative orthodontics (P>0.05).
50% of tracheostomy-dependent patients were decannulated postoperatively.

Conclusions:

Curvilinear MDO provides significant and relatively stable cephalometric improvements in patients with mixed dentition.
The procedure positively impacts mandibular skeletal and occlusal plane morphology.
Further long-term studies are warranted to fully understand the risk/benefit ratio of curvilinear MDO.