Distraction Osteogenesis of the Maxillofacial Skeleton: Clinical and Radiological Evaluation

Bimaxillary deficiencies (BMD) are frequently observed in adult patients and an increasingly recognized major orthodontic problem. Transverse skeletal deficiency (TSD) is a common clinical problem associated with narrow basal and dentoalveolar bone. An adequate transversal dimension is an important factor of stable occlusion and it positively effects facial esthetics and mastication. Narrow and V-shaped dental arch, dental crowding, posterior cross-bite, unesthetic black buccal corridors upon smiling and BMD are generally interrelated (Matteini & Mommaerts, 2001; Mommaerts, 1999; Mommaerts et al., 2004a; Proffit et al., 1996; Ramieri et al., 2005; Vanarsdall, 1999). Additionally, mouth breathing results in many clinical problems such as, xerostomia, an increased caries incidence and recurrent upper air way infections in these cases. Ideal functional reconstruction should achieve sufficient alveolar height and thickness, allowing for permanent restoration of dentition, maxillo-mandibular occlusion, mastication, deglutition, mandibular continuity, sensibility of the mucosa, lip competence and speech. The general aim of oral reconstruction is to restore both normal physiology and facial esthetics. Attention to the transverse deficiencies is vital in planning treatment for a patient who requires an increase in the lateral dimension of the mandible or maxilla.