Dentoalveolar distraction osteogenesis combined with surgical orthodonthic treatment for a patient with jaw deformity and ankylosed maxillary canine – A case report

In surgical orthodontic treatment, the presence of an ankylosed tooth makes it difficult to achieve the desired dental arch morphology. Single tooth osteotomy and dentoalveolar distraction osteogenesis (DO) combined with surgical orthodontic treatment for a patient with jaw deformity and an ankylosed maxillary canine is described in this report. A 37-year-old female was referred to our clinic with a chief complaint of anterior crossbite and was diagnosed with skeletal mandibular protrusion. During preoperative orthodontic treatment for surgical orthodontic treatment, her upper right canine did not move and was diagnosed as an ankylosed tooth. Therefore, we decided to perform a single tooth osteotomy and dentoalveolar DO of the right maxillary canine. Instead of using a commercially available distractor, the dentoalveolar DO in this case was performed using a homemade device with orthodontic biomechanics to move the ankylosed tooth with its supporting alveolar bone and soft tissue into the correct position. After preoperative orthodontic treatment, orthognathic surgery with Le Fort I osteotomy and bilateral sagittal split osteotomies was performed. However, root resorption of the right upper canine continued, and the resorption area was therefore restored with composite resin 10 months after orthognathic surgery to improve the function and esthetics of the maxillofacial region. One and a half years have passed since the orthognathic surgery, and the skeletal stability is good, and the patient is progressing well.