1 1 Bd du Guillon, Résidence Le Mille Pas, 38500 Voiron, France
2 Centre Hospitalier, B.P. 217, 38043 Grenoble Cedex 09, France
3 Département d'Orthopédie Dento-Faciale, Faculté
d'Odontologie, 11 rue Guillaume Paradin, 69372 Lyon Cedex 08, France
Facing a dental crowding, the orthodontist has several therapeutic options.
If maxillary expansion is often used, mandibular orthodontic expansion is
proscribed because of its tendency of inefficiency and relapse. Mandibular
symphyseal distraction osteogenesis allows to remove this proscription. This
therapeutic protocol consists in a pre-surgery orthodontic preparation phase
followed by surgery (symphyseal osteotomy and placement of the distraction
device), a latency period (five to seven days), then an activation period
(most of the time 1 mm/day in two steps) followed by a consolidation period
(three months) during which the orthodontic treatment can be resumed.
Skeletal and alveolar expansion corrects dental crowding. This surgical
technique is versatile, minimally invasive, and stable with time. Major
indications are hypoplastic symphysis, anterior crowding, relapse of
orthodontic treatments and some syndromes. This method can also be an answer
to aesthetic concerns or an alternative for treatment of dental crowding.