Skeletal and dental effects of tooth-borne versus hybrid devices for mandibular symphyseal distraction osteogenesis

Angle Orthod. 2014 Jan;84(1):68-75. doi: 10.2319/022213-154.1. Epub 2013 Jun 20.

Abstract

Objective: To evaluate and compare, retrospectively, the skeletal and dental effects of mandibular symphyseal distraction osteogenesis (MSDO) achieved through the use of tooth-borne versus hybrid distractors.

Materials and methods: Pretreatment (T1), predistraction (T2), postdistraction (T3), and posttreatment (T4) orthodontic records were collected and analyzed for 47 patients (20 tooth-borne, 27 hybrid). At each time point, records included intraoral photographs, study models, postero-anterior cephalometric radiographs, and lateral cephalometric radiographs. Submental vertex radiographs were taken at T2, T3, and T4. Changes in a total of 18 measurements were analyzed to compare patients undergoing tooth-borne versus hybrid distraction.

Results: The cumulative effects of orthodontics and MSDO produced similar gains in measured arch widths, with a decreased irregularity index in both groups (P > .05). However, there were differences in the timing during which the expansion was achieved. The hybrid distractor group gained space during the distraction phase of treatment. The tooth-borne group showed greater gains during pre- and postdistraction orthodontics. Comparisons of intercanine and interbone marker widths demonstrated a more parallel separation of bone during distraction with the hybrid distractor (P < .001). Distraction with the tooth-borne distractor was disproportionate, with greater separation of the canines in alveolar bone than of the bone markers in basal bone. During postdistraction orthodontics, the tooth-borne distractor group showed statistically greater increases in measurements.

Conclusion: Both skeletal and dental expansion was achieved with both appliances. Greater skeletal expansion was achieved with a hybrid distractor. Greater dental expansion was achieved with a tooth-borne distractor.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Alveolar Process / pathology
  • Bicuspid / pathology
  • Bone Regeneration / physiology
  • Cephalometry / methods
  • Child
  • Cuspid / pathology
  • Dental Arch / pathology
  • Dental Arch / surgery*
  • Equipment Design
  • Fiducial Markers
  • Follow-Up Studies
  • Humans
  • Incisor / pathology
  • Mandible / pathology
  • Mandible / surgery*
  • Mandibular Condyle / pathology
  • Models, Dental
  • Molar / pathology
  • Orthodontics, Corrective / instrumentation
  • Osteogenesis, Distraction / instrumentation*
  • Osteogenesis, Distraction / methods
  • Photography, Dental / methods
  • Retrospective Studies
  • Tooth / pathology*