| Devices & Techniques: Intraoral Distraction | ||
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| Devices & Techniques: Intraoral Distraction | ||
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The initial development of intraoral mandibular distraction progressed in two directions: 1) modification of available orthodontic expansion appliances, and 2) further miniaturization of external devices (Cope et al., 1999a).
In 1987, Guerrero applied the first intraoral tooth-borne appliance for osteodistraction of the mandibular symphysis. In 1990, he reported the results of intraoral mandibular widening on eleven patients with transverse deficiencies ranging from 4 to 7 mm (Guerrero, 1990). He used the same principles that Bell and Epker described for palatal expansion of the maxilla (Bell & Epker, 1976). After a vertical symphyseal osteotomy, a custom made Hyrax appliance was placed and initially activated 48 hours after surgery. Depending upon the resistance of the soft tissues, 2 to 4 activations were applied per day to achieve the desired expansion. Upon the completion of distraction, acrylic was flowed around the distraction appliance in order to stabilize and maintain the expansion.
FIG. 3.3.1. Guerrero's intraoral distraction osteogenesis technique for mandibular widening.
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