Archwise Distraction Osteogenesis for Reconstruction of Alveolar Defects in Lip and Palate :A Case Series

Gökoğlu E. İ., Efeoğlu C., Titiz Yurdakal S., Koşer N. D.

FDI World Dental Congress 2026, Praha, Çek Cumhuriyeti, 4 - 07 Eylül 2026, ss.1-20, (Tam Metin Bildiri)

  • Yayın Türü: Bildiri / Tam Metin Bildiri
  • Basıldığı Şehir: Praha
  • Basıldığı Ülke: Çek Cumhuriyeti
  • Sayfa Sayıları: ss.1-20
  • Dokuz Eylül Üniversitesi Adresli: Evet

Özet

Introduction
Management of maxillary hypoplasia and alveolar defects in cleft lip and palate (CLP) patients remains challenging. Conventional bone grafting or orthognathic procedures may require multiple surgeries and may not adequately restore arch continuity. Archwise Distraction Osteogenesis (AWDA) is an alternative dentoalveolar distraction technique that enables segmental transport along the natural dental arch, allowing gradual reconstruction of alveolar defects.

Case Presentation
This case series presents three CLP patients aged 16, 18, and 21 years with maxillary hypoplasia and alveolar defects. Following orthodontic preparation, horizontal and vertical osteotomies were performed under general anesthesia to mobilize the transport segments. After a 7-day latency period, distraction was initiated at a rate of 1 mm per day (0.5 mm twice daily). Segmental transport continued until arch continuity was achieved, followed by a consolidation phase for bone maturation. Clinical and radiographic evaluation revealed improved arch form, occlusal stability, and facial esthetics.

Discussion
AWDA provides several advantages, including arch-form guided bone regeneration, reduction of alveolar defect size, and simultaneous soft tissue adaptation. In selected cases, it may reduce the need for orthognathic advancement procedures. However, the technique requires meticulous orthodontic preparation and careful surgical planning. Potential limitations include root injury during osteotomy, vector control challenges in bilateral cases, and the need for metal crowns on transport and anchorage teeth for appliance stabilization.

Conclusion
AWDA represents a predictable alternative for reconstruction of alveolar defects in CLP patients, enabling controlled segmental movement and simultaneous tissue regeneration within a multidisciplinary treatment approach.