Growth of the maxillary apical base in post-adolescents with craniofacial dysmorphism using ATOZ™ orthodontic distraction osteogenesis

Recent innovations in orthodontic devices utilizing orthodontic mini-implants and mini-screws have allowed orthodontists to enhance the management of craniofacial skeletal disparities nonsurgically. The ATOZ™ orthodontic distractor was invented in 2017 in Korea with the primary directive of growing the maxillary apical base without involving teeth or general anesthesia-required surgery in its application. Its 8.2 mm transverse footprint is ideal for patients who display craniofacial dysmorphism with a severely constricted maxillary apical base. ATOZ™ can withstand up to 50 kg-force of compression without permanent deformation and reverts to its original shape effortlessly. This unique property allows ATOZ™ to apply heavy orthopedic force to the median palatine suture and circummaxillary sutures in a continuous manner over a long period of time. Three exemplary clinical cases treated with ATOZ™ are presented in this article with an emphasis on its slow activation protocol, different from the conventional rapid activation protocol for Rapid Palatal Expander (RPE) or Mini-implant Assisted RPE. With its innovative design and unique biomechanical property of springiness coupled with the slow activation protocol inducing physiological sutural distraction osteogenesis, ATOZ™ may present a ground-breaking opportunity in enlarging the maxillary apical base without adverse effects for post-adolescents with craniofacial dysmorphism and reduce the need for complex craniofacial surgeries.