Mandibular Lengthening: Andrade
3 of 9

Alberto Andrade-Guerra, DDS

Distraction Appliance

The Intraoral Independent/Simultaneous Bilateral Mandibular Expander consists of two telescoping cylinders connected to each other anteriorly by a U-shaped wire. The arch wire is affixed to the patient's chin by screws or to the anterior teeth using a circumferential wire. Posteriorly, each telescoping cylinder includes a fixation wire with terminal forks that are attached to the mandibular ramus by screws. The device is fabricated using commercially pure titanium (Ti₉₀Al₆V₄). Full expansion of the telescoping cylinder produces up to 30 mm of distraction. For additional lengthening, the telescoping cylinder can be replaced with a longer one during distraction.

FIG. 6.1.14.1. Diagram of the distraction device demonstrating its structure and the principles of operation for mandibular lengthening.