Mandibular Lengthening: DynaForm™
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Cesar A. Guerrero, DDS, William H. Bell, DDS

Osteotomy & Device Placement

• Make a 3 cm full thickness incision over the external oblique line, midway up the ascending ramus and extending inferiorly over the alveolar ridge to a position opposite the 1st and 2nd molars.

• Perform a subperiosteal tunneling dissection using a periosteal elevator to expose the buccal cortex, mandibular angle, and alveolar ridge. The periosteum, muscles, and soft tissue are minimally detached to maintain blood supply.

• With an inferior border channel retractor positioned between the 2nd and 3rd molars, use a reciprocating saw to etch the planned osteotomy into the mandibular surface and transect the cortical bone at the inferior mandibular border.

FIG. 6.1.10.1. After incision and dissection, the planned osteotomy is etched into the mandibular surface. Note that throughout the entire process of performing the subtotal osteotomy, irrigate the region with copious amounts of normal saline to minimize thermal bone injury. Take care to preserve the dental follicles and inferior alveolar nerve.