Transversal deficit and anterior teeth crowding are common defect of the mandibular arch, in particular when we deal with skeletal II class malocclusion. When dental space for dental alignment is not recover with usual orthodontic movements, mandibular premolar tooth extraction may necessary in combination with the upper premolar extraction in other to maintain correct molar I Class relationship. Final result is an improvement in function and stability of the occlusion, but with a possible unaesthetic flattening of the profile. The bimaxillary transversal distraction osteogenesis technique may overcome the need of tooth extraction. The purpose of this procedure is to enlarge the bony space of the jaw available for dental repositioning avoiding bone grafting but using the new bone formation induced by the distraction osteogenesis technique.
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