Case Study PH

Ms. PH presented to my office in spring of 2000 for consultation to remove her wisdom teeth and advance her lower jaw. She had undergone orthodontic treatment some years ago but failed to have mandibular advancement to complete the treatment plan.

Examination of PH revealed that she had 4 wisdom teeth which needed to be removed. Additionally she had an 11mm overjet that was mode worse by the tipping of her upper front teeth outward.

I discussed the various options with her and felt that distraction osteogensis surgery would be her best option due to the amount of advancement her lower jaw would need. Although she was not currently in orthodontics I felt I could give her an acceptable result by moving her lower jaw forward to a point where an orthodontist could easily finish her case.

In March of 2000 PH had her wisdom teeth removed and then in May of 2000 she underwent the surgery to fracture her lower jaw and place the distraction devices on each side of her jaw. After a week of healing I began distracting the lower jaw forward at a rate of 1mm every day until her lower jaw was sufficiently advanced to give her a more appropriate bite.

Approximately 10 months after the distraction was completed she had the devices removed without event in the office. She is currently 4 years after surgery and doing well.

Fig 1 a: pre-distraction frontal	Fig 1 b: pre-distraction profile
Fig 1 c: pre-distraction cephalometric x-ray	Fig 1 d: pre-distraction occlusion
Fig 2 a: 1 year after distraction surgery frontal	Fig 2 b: 1 year after distraction surgery profile
Fig 2 c: 1 year after distraction surgery cephalometric x-ray	Fig 2 d: 1 year after distraction surgery occlusion
Fig 3: 1 year after distraction surgery panorex