Mandibular symphyseal distraction osteogenesis: review of three techniques

Int J Oral Maxillofac Surg. 2007 Feb;36(2):111-7. doi: 10.1016/j.ijom.2006.11.005. Epub 2007 Jan 16.


Mandibular symphyseal distraction osteogenesis (MSDO) is an alternative strategy to correct mandibular transverse deficiencies and dental crowding. Only a limited number of practitioners have reported their clinical experience and potential complications of this procedure to widen the mandible in a large case series. This study involved retrospective analysis of 40 patients who underwent mandibular symphyseal distraction osteogenesis. Three different types of distractor were used to widen the mandible: tooth-borne in 21 patients, bone-borne in 5 patients and hybrid (both bone and tooth-borne) in 14 patients. The distraction amount ranged from 7 to 11 mm (mean 7.31 mm). While 39 patients underwent successful mandibular symphyseal distraction, there was one failure. Most of the complications were experienced in bone-borne distractors, such as breakage of the distractor rod, gingival recession, secondary infection and ptosis of the chin. In the light of these findings, it is suggested that a lingually placed tooth-borne hyrax appliance is more suitable and reliable than the other distraction devices. Further larger studies are needed in order to better evaluate the effectiveness of bone-borne or hybrid devices.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Child
  • Chin / surgery
  • Equipment Failure
  • External Fixators / adverse effects
  • Female
  • Gingival Recession / etiology
  • Humans
  • Male
  • Malocclusion / surgery*
  • Mandible / surgery*
  • Osteogenesis, Distraction / adverse effects
  • Osteogenesis, Distraction / instrumentation*
  • Osteogenesis, Distraction / methods*
  • Retrospective Studies
  • Surgical Wound Infection / etiology