Tooth Viability Following Distraction Osteogenesis in Patients with Maxillary Hypoplasia

Thesis (Master's)--University of Washington, 2016-06

Examination of patients with severe maxillary retrusion following maxillary distraction osteogenesis (MDO) finds variable disruptions in tooth development. This study explored maxillary osteotomy type and tooth development stage at time of surgery on long-term viability of teeth. Records of 46 patients that received MDO met inclusion criteria: 22 with Le Fort I and 24 with Le Fort III. Dermirjian’s method was used to assess tooth development on pre-distraction and follow up radiographs. Tooth viability was scored by analyzing tooth position, development, and predicted functionality. Second molars in earlier stages of development at surgery had more nonviable outcomes. Teeth in late development stages at surgery had no unfavorable outcomes. For all tooth types, teeth with more advanced development at surgery had better viability scores than those in earlier stages. This information applies to risk/benefit discussions when planning MDO. For patients without urgent indications, delaying surgery may reduce tooth development disruption