Maxillofacial Plastic and Reconstructive Surgery

Korean Association of Maxillofacial Plastic and Reconstructive Surgeons (대한악안면성형재건외과학회)
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A CASE REPORT OF COMPLICATIONS DURING MANDIBULAR TRANSVERSE SYMPHYSIS WIDENING

하악 이부 확장술 시 나타나는 합병증의 치험례

  • Suh, Chung-Whan (Department of Orthodontics, School of Dentistry, Wonkwang University) ;
  • Kang, Kyung-Hwa (Department of Orthodontics, School of Dentistry, Wonkwang University) ;
  • Choi, Moon-Gi (Department of Oral & Maxillofacial Surgery School of Dentistry, Wonkwang University)
  • 서충환 (원광대학교 치과대학 교정학교실) ;
  • 강경화 (원광대학교 치과대학 교정학교실) ;
  • 최문기 (원광대학교 치과대학 구강악안면외과학교실)
  • Published : 2008.09.30
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Abstract

Orthodontists often treat cases which are difficult to treat with conventional orthodontics. In such cases, it could be treated with surgical procedures with the help of an oral surgeon. Especially, transverse deficiency of the mandible can be corrected by widening the transverse width of mandibular symphysis, using distraction osteogenesis. Transverse widening of mandibular sympysis is known as a safe treatment but still complications could occur during the treatment. We are reporting some complications of cases that mandibular symphysis transverse widening were applied. Some cases showed complications because of the inappropriate osteotomy line. Since straight vertical osteotomy line was inclined to the left, only the left bony segment was likely to expand. According to bio-mechanical considerations, it will be better to perform a step osteotomy, cutting the eccentric area of the alveolar crest and the centric area of the basal symphyseal area. Complications could also occur by the failure of the distraction device. The tooth borne distraction device was attached on the lingual side of the tooth with composite resin. During the distraction period, it was impossible to obtain appropriate distraction speed and rhythm because of frequent fall off of the distraction device. Therefore, distraction device should be attached firmly with orthodontic band or bone screw, etc. Tooth mobility increasement could also occur as a complication. 'Walking teeth phenomenon' was observed during the distraction period, showing severe teeth mobility and pain during mastication. These symptoms fade out during the consolidation period. Since the patient could feel insecure and uncomfortable, it should be notified to the patient before the procedure. Finally, alveolar crestal bone loss could occur. Alveolar crestal bone loss occurred because of lack of distraction device firmness and teeth trauma caused by lower lip biting habit. Therefore, adequate firmness of the distraction device and habit control will be needed.

Keywords

References

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