5�� in gonial angle and an increase of 11 mm in ramus height on the affected side after treatment. In both patients the horizontal overjet was reduced with treatment and the convexity angle became more obtuse. A mean of 7 mm correction was selleck chemicals achieved in relation to craniofacial midline. Follow up records indicated 1 mm of relapse in horizontal overjet in patient 4 and 0.2 mm of relapse in horizontal overjet and 1�� of relapse in convexity angle in patient 5. The results of lateral cephalometric analysis are shown in Table 2. Pre- and post-treatment photographs and radiographs along with pre-treatment study casts of patient 2 are shown in Figures 2 and and3.3. Pre-and post- treatment photographs and radiographs of patient 5 are shown in Figures 4 and and55.

Figure 2 (a�Cc) Pre-treatment study casts, (d�Cf) pre-treatment extra-oral photographs, (g) pre-distraction lateral cephalometric radiograph and (h) pre-distraction panoramic radiograph of Patient 2. Figure 3 Post-treatment (a�Cc) intra-oral photographs, (d�Cf) extra-oral photographs, (g) lateral cephalometric radiograph and (h) panoramic radiograph of Patient 2. Figure 4 Pre-treatment (a�Cc) intra-oral photographs, (d�Cf) extra-oral photographs, (g) lateral cephalometric radiograph, (h) PA cephalometric radiograph and (i) pre-distraction PA cephalometric radiograph of Patient 5. Figure 5 Post-treatment (a�Cc) intra-oral photographs, (d�Cf) extra-oral photographs, (g) lateral cephalometric radiograph and (h) PA cephalometric radiograph of Patient 5. Table 2 Results of lateral cephalometric analysis.

DISCUSSION Bilateral sagittal split osteotomy (BSSO) and distraction osteogenesis are the most common techniques currently applied to surgically correct mandibular deformities. Although randomized clinical trials are lacking, some support was found in the literature for distraction osteogenesis having advantages over BSSO in the surgical treatment of low and normal mandibular plane angle patients needing greater advancement (greater than 7 mm). In all other mandibular retrognathia patients the treatment outcomes of distraction osteogenesis and BSSO seemed to be comparable.28 Differential growth and conventional orthognathic procedures become more difficult and less predictable when correcting severe mandibular deficiencies requiring lengthening of the mandible more than 8�C10 mm.

29 The primary Brefeldin_A advantage claimed in connection with distraction osteogenesis is that it allows major reshaping of the facial bones without bone grafts or jaw wiring. It is believed that distraction osteogenesis may be safer than other methods of facial reconstruction, since it can involve less blood loss and a lower risk of infection.30 Moreover, reports on patients with cleft palate have suggested that maxillary advancements achieved by distraction are more stable than the advancements achieved with orthognathic surgery.31,32 The specially fabricated hardware used for the distraction process can be internal or external.