Correction of Lateralization of the Intermediate Segment in Biplanar Distraction Osteogenesis of the Mandible using External Elastics: A Non-Invasive Innovative Technique with a case presentation.

Abstract

Biplanar distraction osteogenesis (DO) is effective for correcting mandibular hypoplasia and asymmetry. However, lateralization of the intermediate segment between the two osteotomy cuts during distraction is a frequent complication that can affect occlusion and facial symmetry. Traditionally managed with invasive surgical correction, this increases morbidity and treatment complexity. We present a non-invasive technique using external orthodontic elastics to correct segment lateralization. A 22-year-old female with bilateral mandibular hypoplasia developed lateralization after biplanar DO. Correction was achieved by applying elastics between an acrylic stop on the intermediate segment and hooks on the fixed body segment. Within 10 days, segment alignment improved significantly without disrupting the distraction process. Cephalometric analysis confirmed a 6.7 mm medial correction. Final outcomes showed improved facial symmetry, stable occlusion, and high patient satisfaction. This technique offers a safe, simple, cost-effective, and minimally invasive alternative to surgical correction of segment deviation during mandibular distraction.