Efficacy and Versatility of Intraoral Monoplanar Distractors in the Correction of Extreme Mandibular Deformities and Severe Facial Asymmetries - A Retrospective Study

INTRODUCTION: Distraction osteogenesis, has emerged as a revolutionary concept and an effective means to treat extensive craniomaxillofacial defects and malformations. In cases of mandibular distraction for patients with extreme acquired mandibular deformities, there is so far, no recorded literature on precise quantification and scientific estimation of the percentage of the efficacy of intraoral monoplanar distractors, for an objective evaluation of their effectiveness. The objective was to study the efficacy of intraoral mandibular monoplanar distractors in the correction of severe acquired mandibular deformities and gross facial asymmetries. To objectively evaluate their effectiveness by calculating the percentage of distraction achieved as against that aimed for, and to evaluate early and late complications encountered with their use. MATERIALS AND METHODS: Five patients in the age group of 10–22 years, with extreme mandibular deformity and gross facial asymmetry secondary to longstanding temporomandibular joint (TMJ) ankylosis, were treated. Four patients had unilateral and one patient had bilateral TMJ ankylosis, with varying degrees of acquired mandibular hypoplasia, retrogenia, retrognathia, and asymmetry. They were managed by unilateral (3 patients) and bilateral (2 patients) mandibular distraction. RESULTS: Maximum horizontal corpus and vertical Ramal distraction achieved was 19 mm and 17.6 mm, respectively. The percentage of the efficacy of the intraoral monoplanar distractors used in this study ranged from 65.38% to 109.09%. Severe mandibular deformities and facial asymmetries were successfully corrected in all five patients, with no major early or late complications encountered in any of them. Results achieved were stable with nil incidence of relapse. DISCUSSION: Estimation of percentage of the efficacy of distraction achieved, helped in objectively evaluating the effectiveness of the intraoral mandibular distractors. A low complication rate and good esthetic and functional outcomes achieved in all the patients demonstrated the reliability of this treatment modality in the management of extreme mandibular deformities and severe facial asymmetries.