Rapid tooth movement and orthodontic treatment using dentoalveolar distraction (DAD). Long-term (5 years) follow-up of a Class II case

Abstract

The purpose of this report is to describe the dentoalveolar distraction (DAD) technique and to present its effects on the surrounding structures by presenting a Class II case. A 15-year-old skeletal and dental Class II female patient with an overjet of 9 mm was treated by DAD osteogenesis. A custom-made, rigid, tooth-borne intraoral distraction device was used for rapid canine retraction. Osteotomies surrounding the canines were made to achieve rapid movement of the canines within the dentoalveolar segment, in compliance with distraction osteogenesis principles. The amount of canine retraction was 7.5 mm in 12 days at a rate of 0.625 mm per day, with no posterior anchorage loss. The canine teeth showed 1.6 mm extrusion and 11 degrees inclination change (distal tipping) during the same period. Orthodontic treatment continued for 6 months with no clinical and radiographic evidence of complications such as root fracture, root resorption, ankylosis, and soft tissue dehiscence. The DAD technique is an innovative method, because it reduces overall orthodontic treatment time by about 50%, with no unfavorable effects on periodontal tissues and surrounding structures and with no need to use any intraoral or extraoral anchorage appliances.

Figures

Figure 1

(a) Panoramic film before treatment. (b) Cephalometric reference points and lines.

Figure 2

Intraoral view of the surgical site. (a) Corticomy. (b) Dentoalveolar distraction device in place. The canine and molar bands were fabricated, and distractors were soldered to the bands on the dental cast.

Figure 3

Dentoalveolar distraction device.

Figure 4

Extraoral photographs of the patient during treatment.

Figure 5

Intraoral occlusal photographs of the patient during treatment.

Figure 6

Intraoral frontal photographs of the patient during treatment.

Figure 7

Intraoral photographs of the patient during treatment (right side).

Figure 8

Intraoral photographs of the patient during treatment (left side).

Figure 9

Periapical films of the patient before DAD.

Figure 10

Periapical films of the patient on the fifth day of DAD.

Figure 11

Periapical films of the patient on the 12th day of DAD.

Figure 12

Periapical films of the patient 3 months after DAD.

Figure 13

Periapical films of the patient 6 months after DAD.

Figure 14

Periapical films of the patient 5 years after DAD.

Figure 15

Intraoral photographs of the patient 5 years after DAD.