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[Symphyseal bone distraction (part 2): which protocol in 2018? A systematic literature review].

A new interesting article has been published in Orthod Fr. 2018 Sep;89(3):279-288. doi: 10.1051/orthodfr/2018027. Epub 2018 Sep 26. English Abstract and titled:

[Symphyseal bone distraction (part 2): which protocol in 2018? A systematic literature review].

Authors of this article are:
Lietz G Gebeile-Chauty S.

A summary of the article is shown below:
INTRODUCTION: The aim of this systematic literature review is to propose a clinical protocol in 2018 by comparing therapeutic efficacy and undesirable effects of the technique.MATERIALS AND METHODS: Searches were made on Pubmed/Medline and Cochrane for randomized clinical trials and case series involving mandibular symphyseal distraction over the past 20 years with a patient sample greater than or equal to 10.RESULTS: Of the 92 articles, 25 met the inclusion criteria. A controlled trial was selected, but no randomized trial. The other studies were all case series, 16 retrospective and 8 prospective. Dental crowding over 7 mm, with or without compensation, is an indication for mid-symphyseal distraction. Pre-surgical orthodontic treatment ensures root divergence between the mandibular incisors. Tooth-borne devices are recommended in first intention. Surgical intervention (ambulatory) under local anesthesia and intravenous sedation is considered. The latency period before activation of the jack is 6 days. Activations are performed by the orthodontist and subsequently by the patient at a rate of 1 mm per day, with four activations daily. Orthodontic movements are resumed two weeks after activations are discontinued. The distractor is removed within two to three months after installation.CONCLUSION: Although the main features of the mid-symphyseal distraction protocol were drawn up essentially in the light of expert opinion, they still need to be refined by controlled trials.© EDP Sciences, SFODF, 2018.

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