Mandibular Widening: DynaForm™
3 of 12

Cesar A. Guerrero, DDS, William H. Bell, DDS

Incision & Subtotal Osteotomy

• Make an incision 4 to 6 mm labial to the depth of the mandibular vestible through the orbicularis oris muscle.

• Direct the dissection obliquely, posteriorly, and inferiorly through the mentalis muscle until contact is made with the mandibular symphysis.

• Carefully reflect the periosteum inferiorly to the lower border of the mandible, where a small channel retractor is placed. Keep in mind that much of the osteodistraction healing capacity originates from the periosteum.

• The soft tissue between the mandibular central incisors should be carefully reflected superior to the alveolar crest using a skin hook.

• Make a vertical osteotomy through the symphyseal area with a reciprocating or oscillating saw blade, starting at the inferior border of the mandible and continuing to the interdental space between the apices of the mandibular incisors.

FIG. 6.2.2.1. Vertical midsymphyseal osteotomy is made with a reciprocating saw blade from the inferior portion of the mental symphysis, below the level of incisors.