**Author details**

The technique is based on a 5-day period of rest after corticotomy before the expansion starts.

**Figure 6.** View of a completed osteotomy. Also zygomatic retention plates are implemented for orthodontic purposes.

**1.** The first is a fibrovascular hematoma; between days 5 and 7 collagen fibers are formed

**2.** Second, the bone formation follows the collagen fibers through intramembranous

**4.** Fourth, formation of solid compact bone with the same texture as the surrounding (old)

When the distraction is performed too fast, the collagen fibers lose contact and there is no ingrowth of new bone, causing nonunion or malunion. In cases of a too slow distraction premature consolidation can occur and the required elongation cannot be reached [53].

**Latency** is considered to be the time interval between osteotomy and the appliance start-up

**Activation rate** is the amount of daily bone distraction (in millimeters); it varies from 0.25 to

**Frequency** represents the number of times the appliance is activated per day. [57] De Freitas et al recommend the expansion procedure with an overexpansion index of 23% above the

**Retention period** at the end of the distraction is necessary for the neoformed bone tissue to acquire the necessary resistance to bear the tipping forces. In experimental and clinical studies

and varies from 0 to 14 days in experimental and clinical studies. [54-56]

This gives the tissue time to form the first callus but is too short for consolidation.

**Four phases of new bone formation** can be described.

ossification; from the outside to the inside.

desired measurements to compensate for relapse [58].

this period can vary from one to six months. [54, 59]

**3.** Third, remodeling phase of the new bone.

126 A Textbook of Advanced Oral and Maxillofacial Surgery Volume 2

bones.

1.0 mm.

that will arrange parallel to the distraction vector.

Sertaç Aktop\* , Onur Gönül, Hasan Garip and Kamil Göker

\*Address all correspondence to: sertacaktop@hotmail.com

Marmara University Dentistry Faculty, Department of Oral and Maxillofacial Surgery, Istan‐ bul, Turkey
