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Alveolar distraction to increase height of chin bone to enhance appearance

13/11/2014

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Ectodermal dysplasia is a rare genetic condition characterized by abnormal development of skin, hair, nails, teeth and sweat glands. A young girl suffering from this condition came to our hospital seeking a fixed replacement of her missing teeth and to correct the shape of her chin which gave her an aged appearance.

A 3D CT scan was taken to gauge the amount of residual bone. Due to the multiple missing teeth over a long period of time, the lower jaw bone was severely resorbed and the vertical height was insufficient to place implants. Maxillofacial Surgeon Dr. S.M. Balaji planned for a surgical reconstruction using alveolar distraction osteogenesis technique. The anterior region of the lower jaw bone was cut and alveolar distractor device was fixed. When the screw attached to the device is gradually turned 0.6 mm daily, the cut segments of bone move apart and new bone is formed in the resultant gap ultimately increasing the bone height which enhances her appearance. 
Preoperative 3DCT view showing reduced height of the alveolar bone in the front region of the lower jaw due to congenitally missing teeth
Preoperative digital OPG showing reduced height of alveolar bone in the lower front region of the mandible
Intraoral view showing reduced height of the alveolar process with illdefined vestibular sulcus in lower anterior region
During procedure mucoperiosteal flap raised to expose the alveolar process of the mandibular anterior region
Bone cut was placed superior to the mental foramen and segmental alveolar distractor was fixed to it
Trial activation was done and movement of the alveolar segment was checked
Mucoperiosteal flap was approximated with sutures
1 week postoperative digital OPG showing moved alveolar segment to increase the height of the chin region
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