[Symphyseal distraction: a simplified procedure].

INTRODUCTION: Severe mandibular incisor crowding with bone insufficiency is usually treated by dental extractions and orthodontic management. Symphyseal distraction was proposed to avoid tooth extraction. This technique is still considered as invasive, complex and unsafe. We evaluated symphyseal distraction to clarify its indications, and to suggest a simplified surgical protocol.

PATIENTS AND METHODS: Six patients were treated by symphyseal distraction: three with a bone-anchored device and three with a dental anchored one. Pre and postoperative inter-canine measurements and occlusal stability were analyzed.

RESULTS: Postoperative inter-canine measurements increased from 3.4 to 6.8mm (mean 5.2mm). All patients were in Angle class I occlusion without complications. Dental anchored device simplified the surgical procedure.

DISCUSSION: Symphyseal distraction with dental anchored device is a simple, efficient and reliable to treat severe transverse mandibular deficiency. The orthodontist can manage the procedure by himself and controls the whole expansion process according to specific requirements.