Mandibular distraction osteogenesis in adolescents as an alternative to orthognathic surgery: a clinical case series

Relevance. Mandibular underdevelopment in adolescents without syndromic pathology is often associated with temporomandibular joint (TMJ) disorders and presents with marked facial asymmetry, malocclusion, and functional impairment. Conventional orthognathic surgery in patients with incomplete facial skeletal growth carries a high risk of relapse and considerable surgical morbidity. Mandibular distraction osteogenesis (DO) is regarded as a less invasive alternative to orthognathic surgery.

Clinical case descriptions. Three adolescents (two females, 17 years; one male, 16 years) with nonsyndromic mandibular hypoplasia secondary to TMJ degenerative changes were included in case series. All patients underwent mandibular distraction osteogenesis using intraoral curvilinear distractors (Conmet, Moscow, Russia). Preoperative planning was performed using multislice computed tomography (MSCT) and lateral cephalometric radiography. Mandibular elongation aranged from 12 to 16 mm. Treatment resulted in substantial correction of facial asymmetry, normalization of occlusion, and satisfactory regenerate quality, as confirmed on CT and ultrasonography. No complications were observed.

Conclusion. In adolescents, intraoral curvilinear distractors provide an effective, minimally invasive approach to correcting nonsyndromic mandibular hypoplasia, reducing the need for orthognathic surgery and minimizing complications.

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