Case Studies (in cooperation with Dr. J.W.D Defrancq, DDS MD)

SMILE DISTRACTOR CASE 1
Patient
  • White female
  • 34 years
History
  • Bilateral cleft.
  • 1990 : Secondary cleft closure in our department. Frontal teeth with crown and bridge were removed, cranial bone graft was performed with simultaneous placement of 3 implants. Subsequently a vestibuloplasty was performed with palatal tissue and implant suprastructure was achieved.
  • In February 2005 she consulted for eventual further treatment, including smile esthetics, genioplasty, and nose – lip surgery.
Treatment Plan
  • Smile distractor placement and genioplasty
  • Temporary adjustment of implant suprastructure in Cr Co - Resine.
  • Extraction of first premolars both sides and implant placement with Ossix (3i) membrane. Nose surgery.
  • Further adjustment of cr co resine.
  • Lip surgery and uncovering of both premolar implants planned in near future.
  • New porcelain implant suprastructure on the five implants in the front and further facings on second premolars and evt molars.
 




SMILE DISTRACTOR CASE 2
Patient
  • White female
  • 37 years
History
  • Agenesis of lateral incisors.
  • Orthodontically the cuspids were moved in the lateral incisor area and crown and bridge work was made in the past.
  • Deficient crown and bridge work appearance, poor smile esthetics, midface deficientcy.
Treatment Plan
  • Smile distractor placement after sectioning of crown and bridge in the front. Recreation of place for two lateral incisors.
  • Orthodontic treatment accordingly.
  • Lefort I advancement is scheduled in near future.
  • Reappraisal of crown and bridge in provisorium. Final decision is left open : implants or conventional crown & bridge.
 

SMILE DISTRACTOR CASE 3

Patient
  • White male
  • 24 years
History
  • Gorlin Goltz syndrom.
  • Class III asymetry, open bite and hypoplasia of maxilla.
  • Multiple keratocysts in the upper jaw. 
  • Previous cyst removals and osteotomies. Cuspids are implants.
Treatment Plan
  • Plate removal of previous osteotomy (14/09/1989) and placement of smile distractor (27/01/2004).
  • april '06: Posterior alveolar segment osteotomy with posterior impaction.
    Bone stabilisation with anterior hipgraft.
    Extraction of the four front teeth and additional placement of two frontal implants (3i).
    Genioplasty slight reduction – advancement.
  • june '06: A gold porcelain bridge was installed on the implants in the front area.
  • july '06: Total stability remained achieved in the tranversal and vertical dimention.
 
before smile distractor
at the end of distration





SMILE DISTRACTOR CASE 4

Patient

  • White female
  • 33 years
History
  • Narrow maxilla and nose base with mid-facial deficiency.
Treatment Plan


 



pre-op. and post-op. situation at and end of distraction.