L'Orthodontie Française


Distraction symphysaire et orthodontie Volume 79, issue 3, Septembre 2008

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
* bastien.lesne@hotmail.fr

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.