Distraction Osteogenesis: New Horizons in Combined Surgical- Orthodontic Treatment of Dentofacial Deformities

Objectives: To evaluate the effects of distraction osteogenesis treatment approach for the correction of dentofacial deformity due to long standing unilateral functional ankylosis.
Methods: A patient with a long standing unilateral functional ankylosis resulting in evident facial deformity was treated with distraction osteogenesis protocol. A multi-disciplinary treatment approach was used. The treatment was divided in to four phases i.e. distraction phase followed by an orthodontic phase, second stage orthognathic surgery phase and the final orthodontic settling phase. Photographic and radiographic analyses were conducted before and after these phases to critically appraise the treatment results.
Results: The desired esthetic, functional and occlusal results were achieved in a total treatment span of 25 months. Post-surgical complications were successfully addressed in the follow up period, strictly adhering to the international treatment protocols and current available evidence.
Conclusions: There is limited documented evidence providing guidelines for the management of facial asymmetry due to long standing functional ankylosis. Close cooperation between maxillo facial surgeon and orthodontist, accurate diagnosis and execution of an efficient treatment plan can help us in achieving optimal treatment results in all three dimensions. The available result is based on a single case report. Effort needs to be extended in establishing a larger sample size, helping us in exploring great potential that lies in the field of distraction osteogenesis.