Long-term results of bilateral mandibular distraction osteogenesis using an intraoral tooth-borne device in adult Class II patients

The aim of this prospective clinical study was to evaluate the short-term and long-term skeletal and dental changes after mandibular osteodistraction with toothborne appliances in adult orthodontic patients. The sample consisted of 10 non-growing Caucasian patients with a Class II skeletal relationship due to mandibular deficiency, together with Class II dental malocclusion. All patients underwent mandibular distraction osteogenesis (MDO) using the ROD1 tooth-borne device. Lateral cephalograms were evaluated at four time intervals: pretreatment (T1), after mandibular distraction (T2), after orthodontic fixed appliance therapy (T3), and at long-term observation 8-year post-distraction (T4). Statistical analyses compared the skeletal and dental changes in intervals T1 T2, T2 T3, T3 T4, T1 T4, and T2-T4. MDO with the ROD1 tooth-borne device produced significant long-term (T1-T4) increases in the SNB angle (2.3 degrees), total mandibular length (5.9 mm), and corpus length (4.5 mm). Potential adverse sequelae included significant increases in mandibular plane angle (4.3 degrees), lower anterior dental height (2.8 mm), and lower posterior dental height (2.5 mm). Significant increases in lower incisor proclination occurred during distraction (7.5 degrees). Distraction osteogenesis with tooth-borne appliances offers a minimally invasive surgical method with stable results for correcting mandibular deficiency in non-growing patients.