Dentoalveolar Segment Research Articles

Canines on a Fast Track: Canine Distalization by Dentoalveolar Distraction Osteogenesis

ABSTRACT Conventional techniques for biological tooth movement is routinely achieved at a slow rate and in high anchorage cases where individual canine retraction is indicated lasts for 6 to 8 months, followed by retraction of the incisors. Hence, the overall treatment time taken is about 18 to 24 months. Rapid canine distalization through dentoalveolar distraction (DAD) technique can be achieved within 2 to 3 weeks with this technique. This clinically efficient method significantly reduces the overall treatment time without causing any serious discomfort or damage to the patient. In this technique osteotomies surrounding the canines are made to achieve rapid movement of the canines within the dentoalveolar segment, in compliance with distraction osteogenesis principles. How to cite this article Virang B, Belludi A, Bhardwaj A, Padmawar S, Virang P. Canines on a Fast Track: Canine Distalization by Dentoalveolar Distraction Osteogenesis. Int J Experiment Dent Sci 2013;2(1):44-49.

Combined Orthodontic and Surgical Approach in the Correction of a Class III Skeletal Malocclusion with Mandibular Prognathism and Vertical Maxillary Excess Using Bimaxillary Osteotomy

For patients whose orthodontic problems are so severe that neither growth modification nor camouflage offers a solution, surgery to realign the jaws or reposition dentoalveolar segments is the only possible treatment. Surgery is not a substitute for orthodontics in these patients. Instead, it must be properly coordinated with orthodontics and other dental treatments to achieve good overall results. Dramatic progress in recent years has made it possible for combined surgical orthodontic treatment to be carried out successfully for patients with a severe dentofacial problem of any type. This case report provides an overview of the current treatment methodology in managing a combination of asymmetrical mandibular prognathism and vertical maxillary excess.

Partial maxillary osteotomy following an unsuccessful forced eruption of an impacted maxillary canine: 10 year follow-up. Review and case report

The maxillary canines are amongst the most frequently impacted teeth, second only to the third molars. Several conservative orthodontic and surgical techniques are available to position the teeth properly in the dental arch, even in severe cases. However, when an extraction is necessary, it often leaves a critical alveolar defect of difficult management. The authors present the technique of Partial Maxillary Osteotomy, in which a dento-alveolar segment is moved mesially, hence closing the remaining space, allowing for the formation of healthy periodontium and resulting in an adequate functional and aesthetic outcome. A case report is presented with a 10 year follow-up, proving the technique's stability in the long term.

Maxillary Movement in Cleft Patients Treated with Internal Tooth Borne Distractor

Cleft lip and palate is associated with maxillary hypoplasia and retrognathism. Surgery and distraction have been the most common treatment approaches used. The aim of this study was to objectively assess the quantum and direction of movement of the anterior maxilla in cleft patients treated with an internal tooth borne distractor. A prospective clinical study design was followed in which 8 consecutive patients with cleft maxillary hypoplasia were included in the age range of 15-25years. All patients had undergone secondary alveolar bone grafting earlier. Anterior maxillary distraction was performed using a tooth borne appliance in all 8 patients after necessary osteotomy. Lateral cephalograms were obtained preoperatively, predistraction and postdistraction. The angular and linear change at the maxillary anterior segment, rotation of the palatal plane, mandibular plane, increase in lower facial height and vertical changes of the anterior and posterior dentoalveolar segments were measured. The movement of the anterior maxillary segment was demonstrated anteriorly and superiorly in all the patients. The anterior and posterior dentoalveolar heights were increased post-distraction. There was also an increase in lower anterior facial height and the mandibular plane angle. Predictable superior and anterior movement of the anterior maxilla along with significant increase in palatal length could be achieved with the internal tooth borne distractor leading to remarkable improvement in esthetics and better function.

Comparative Analysis of Osteosynthesis of Mandibular Anterior Fractures Following Open Reduction Using ‘Stainless Steel Lag Screws and Mini Plates’

The purpose of this study was to compare the outcome of open treatment of mandibular fracture (symphysis or parasymphysis) using lag screw or mini plate clinically as well as radiologically in young (age range 12-45years) and healthy individuals of poor socioeconomic status. This prospective study was conducted on 30 patients diagnosed as cases of displaced mandibular anterior fractures treated with open reduction and internal fixation. The patients were then randomly allocated to either of two groups--Group A: Two 2.5mm stainless steel lag screws were placed in 15 patients. Group B: Two 2.5mm stainless steel mini plates were placed in 15 patients for the fixation of fractures. Subsequent follow up was done on 2nd, 4th, 6th and 8th week postoperatively. During every follow up patient was assessed clinically for infection, malocclusion, loosening of plate/screw, sensory disturbance, plate fracture, malunion/non-union, devitalisation of associated dentoalveolar segment and masticatory efficiency. Radiographs were taken if necessary and patients were further assessed for any complaint. Pain was objectively measured using a visual analogue scale, bite force was measured using a bite force transducer at biweekly interval. The data collected was subjected to unpaired t test and paired t test for statistical analysis. During follow up period a significant improvement in bite force was present in both the groups, with more improvement seen in the lag screw group (p<0.01). There was a significant pain reduction present in the lag screw group (p<0.01) and also masticatory efficiency showed a steadier improvement in lag screw group while mini plate group patients showed a tendency to masticate only food items of medium hard consistency. The sample size is small to conclude lag screws are better than mini plates but the result of our study provides a basis for further studies done to conclude that the application of LAG SCREW is an effective, inexpensive, quick treatment modality to accelerate healing of fresh, displaced mandibular anterior fracture.

Closure of the Alveolar Cleft by Bone Segment Transport Using an Intraoral Tooth-Borne Custom-Made Distraction Device

The fact that bone transportation generates not only bone but also surrounding soft tissues makes it an ideal technique for tissue regeneration. This study evaluates bone segment transport using an intraoral tooth-borne distraction device for alveolar cleft closure. Patients with an alveolar cleft were enrolled in the study. They were treated at the Al-Azhar University Hospital, Cairo, Egypt, between 2004 and 2007. Anterior transportation of the posterior dentoalveolar segment was performed by use of an intraoral tooth-borne custom-made distractor. Clinical evaluations included the following: preoperative and postoperative intraoral photographs, vitality testing of the teeth in the transport segment, cast analysis, and measurement of tooth mobility. Radiographic evaluations included occlusal films, orthopantomography, and computed tomography and 3D computed tomography for volumetric and densitometric evaluations of the distracted bone. After distraction was completed, the transported segments were positioned 1 to 4 mm superior to the occlusal plane. The radiographic evaluation showed residual triangular bone deficits that were closed through gingivoperiosteoplasty or bone grafting. Once the transported segments came in contact with the alveolar bone of the normal side, the intervening fibrous tissue at the docking site was removed, and docking-site surgery was then performed. The results obtained from both clinical examinations and radiographic imaging showed complete closure of the alveolar clefts. Maxillary alveolar bone transport offers an alternative technique in the latest treatment of the alveolar cleft.

Onychophagia (Nail biting), anxiety, and malocclusion

Nail biting is a stress removing habit adopted by many children and adults. People usually do it when they are nervous, stressed, hungry, or bored. All of these situations are having a common phenomenon between them is anxiety. Onychophagia is also a sign of other emotional or mental disorders. It is a habit that is not easy to quit and reflection of extreme nervousness or inability to handle stressful conditions. This abnormal habit may cause various malocclusions associated with dentoalveolar segment of the oral cavity. Crowding and rotations of incisors are common with this habit.

Myofibromas of the Jaws in Children

Controversy exists as to the most appropriate treatment strategy for myofibromas of the jaws: en bloc resection versus enucleation. The purpose of the present study was to evaluate the treatment outcomes in children with these uncommon benign tumors. We performed a retrospective chart review of pediatric patients with jaw myofibromas. The predictor variables included patient demographics, clinical presentation, imaging characteristics, pathologic features, treatment, and follow-up. The outcome variable was cure or recurrence. The descriptive statistics were computed. A total of 12 patients (mean age 6.7 years) met the inclusion criteria. There were 2 presentations: exophytic soft tissue mass in dentoalveolar segment (n = 5); and intraosseous mass (n = 7). No distinct histopathologic differences were found between the 2 groups. Exophytic myofibromas displayed rapid growth, tooth displacement and/or mobility, bony expansion, and/or cortical thinning/perforation. Most were treated by resection. The intraosseous lesions were asymptomatic and/or incidentally discovered. They were treated by enucleation and curettage. The mean follow-up for the 2 groups was 6.5 and 3.9 years, respectively. There were no recurrences. The results of the present study indicate that there are 2 clinical presentations of myofibromas of the jaws in children: an aggressive exophytic type and a nonaggressive intraosseous type. They are histopathologically indistinguishable.

Effects of latency on the quality and quantity of bone produced by dentoalveolar distraction osteogenesis

Infrabony defects in the alveolus pose a substantial treatment complication for restorative dentists. The properties of regenerate bone produced by dentoalveolar distraction, with and without a latency period, remain largely unknown. Six male foxhound dogs between 1 and 2 years of age underwent osteotomies around the mandibular second premolar to create a dentoalveolar segment that was distracted (1 mm/day for 10 days) through a large periodontal defect created in the third premolar area. A split-mouth design was used, with 1 randomly selected side starting distraction immediately, and the other side starting distraction after a 5-day latency period. The nonlatency and latency sides had 7 and 6 weeks of consolidation, respectively. Microcomputed tomography scans (taken at 15 and 60 μm) were used to evaluate bone quality and quantity of the regenerate bone, as well as the maturational differences in the regenerate. The transport segments were distracted 7 to 8 mm over 10 days. The majority (>75%) of the specimens showed complete or almost complete vertical and buccolingual bone fill. Except for trabecular separation, there were no significant differences between the latency and nonlatency sides in the quantity or quality of bone produced. Although relative bone volume tended to increase between the mesial and distal aspects of the regenerate, there were no significant differences in material properties in the regenerate. The control bone was denser and greater in quantity than the regenerate bone. Except for slight differences in maturation, latency had little or no effect on the regenerate bone produced. Dentoalveolar distraction immediately after alveolar bone surgery appears to produce bone of adequate quantity and quality for dental implant restorations.

Alveolar crest regeneration using curvilinear dentoalveolar distraction osteogenesis: a preliminary study

The objective of this study was to reconstruct alveolar crest at home position using distraction osteogenesis (DO) with a personalized curvilinear distractor designed through computer-aided technology. Five adult dogs were recruited and the maxillary alveolar bone from the first incisor to the first premolar was excised. The dentoalveolar segment adjacent to the defect was osteotomized as a bone transport disk. After 8 weeks of consolidation, the dogs were humanely killed, and the regenerated bone was analyzed. The DO was successful in the experimental group. The radiographs and histology both verified new bone bridging distraction gap. However, the newly formed bone was located more internally and was not in original position. The proposed method to reconstruct alveolar crest at home position is improper. The key point was how to maintain the distraction space and hold it at the home position. The barrier membrane technique may be used together with DO to resolve the problem.

Rapid Tooth Movement and Orthodontic Treatment Using Dentoalveolar Distraction (DAD)

The purpose of this report is to describe the dentoalveolar distraction (DAD) technique and to present its effects on the surrounding structures by presenting a Class II case. A 15-year-old skeletal and dental Class II female patient with an overjet of 9 mm was treated by DAD osteogenesis. A custom-made, rigid, tooth-borne intraoral distraction device was used for rapid canine retraction. Osteotomies surrounding the canines were made to achieve rapid movement of the canines within the dentoalveolar segment, in compliance with distraction osteogenesis principles. The amount of canine retraction was 7.5 mm in 12 days at a rate of 0.625 mm per day, with no posterior anchorage loss. The canine teeth showed 1.6 mm extrusion and 11 degrees inclination change (distal tipping) during the same period. Orthodontic treatment continued for 6 months with no clinical and radiographic evidence of complications such as root fracture, root resorption, ankylosis, and soft tissue dehiscence. The DAD technique is an innovative method, because it reduces overall orthodontic treatment time by about 50%, with no unfavorable effects on periodontal tissues and surrounding structures and with no need to use any intraoral or extraoral anchorage appliances.

Evaluating the mandible with cone-beam computed tomography

The purpose of this research was to examine methods for assessing the shape and growth of the mandible 3 dimensionally. Furthermore, 1 method was defined and applied. Thirty mandibles were assessed. An average or mean shape was determined, and the mandibles were ranked quantitatively, by using the root mean square (RMS), according to their variation from the mean. The rankings ranged from mandibles that were small, short, and narrow at the minus-RMS end, to large, tall, and broad at the plus-RMS end. A second analysis provided a method to superimpose a mandible over the average mandible and determine the differences from the average-derived mandible by using a spectrum of colors to indicate changes in a region. Variations in the mandible were greatest in the condylar heads, coronoid tips, canine-incisor dentoalveolar segment, and chin point. The visual images of the 30 segmented mandibles suggest that a new method of classification needs to be developed that extends the original 2-dimensional lateral evaluation to a total 3-dimensional view that provides new relationships, such as the direction of the condylar heads to the ramus and the ratio of the intergonial angle length to the intercondylar head length to define the narrowness of a mandible.

Surgical-orthodontic treatment of a skeletal class III malocclusion

For patients whose orthodontic problems are so severe that neither growth modification nor camouflage offers a solution, surgery to realign the jaws or reposition dentoalveolar segments is the only possible treatment option left. One indication for surgery obviously is a malocclusion too severe for orthodontics alone. It is possible now to be at least semiquantitative about the limits of orthodontic treatment, in the context of producing normal occlusion as the diagrams of the “envelope of discrepancy” indicate. In this case report we present orthognathic treatment plan of an adult female patient with skeletal class III malocclusion. Patient's malocclusion was decompensated by orthodontic treatment just before the surgery and then normal jaw relationship achieved by bilateral sagittal split osteotomy.

Periodontal tissues changes in tooth-borne distraction osteogenesis: an experimental study of closure of wide alveolar bone defects in dogs

We studied changes in periodontal tissue during maxillary dentoalveolar distraction osteogenesis using an intraoral tooth-borne distractor to close wide alveolar defects in four dogs. The dentoalveolar monofocal transport disc was made by complete horizontal subapical and vertical interdental osteotomy. Gradual distraction was started after a latency period of seven days at the rate of 0.4 mm twice a day. We measured the displacement of the supporting tooth and the anchoring tooth, and took successive radiographs. On days 0, 14, 28, and 70 after distraction, the dentoalveolar segments were harvested for histological examination. There was periodontal hyperplasia in the tissues of the tension side, and absorption in the stress side. In the early period of consolidation, there was inflammation and local destruction of periodontal tissues, but the changes reversed over time. The anchoring tooth was not displaced and the periodontal tissues did not change. Morphological changes in the periodontal tissues of the supporting tooth were moderate and, like the physiological changes of the periodontal ligament of the orthodontic tooth, could be reversed if the rate and duration of distraction were correct.

Noncompliance Open-Bite Treatment with Zygomatic Anchorage

To evaluate the dentoalveolar and skeletal effects of the new-generation open-bite appliance. The study group was composed of 11 subjects with a mean age of 19.5 years who underwent intrusion of the posterior dentoalveolar segment using an open-bite appliance supported by bilateral zygomatic implants. The study was carried out on lateral cephalograms of the subjects taken before treatment and after intrusion. The mean intrusion time was 9.6 months. The mean intrusion measured as the distance of the U6 to the palatal plane was 3.6 +/- 1.4 mm (P < .001). This resulted in an average of 3.0 degrees +/- 1.5 degrees of closure of the Go-Gn-SN angle (P < .001). The gain in the overbite was 5.1 +/- 2.0 mm (P < .001), and the overjet was reduced by 1.4 +/- 1.5 mm (P < .01). The change in the occlusal plane angle was an average of 2.4 degrees +/- 1.4 degrees counterclockwise rotation (P < .001). The lower facial height was also decreased significantly by 2.9 +/- 1.3 mm (P < .001). No significant changes were observed in the SNA angle and incisor positions (P > .05), except for the interincisal angle, which was increased by 3.5 degrees (P < .05). Zygomatic anchorage can be used effectively for open-bite correction through posterior dentoalveolar intrusion.

Poster 178: Stability of the Maxilla After Superior Repositioning With the Total Maxillary Alveolar Osteotomy

Statement of the ProblemThe purpose of this study was to investigate the postoperative stability of the maxilla following the total maxillary alveolar osteotomy (TMAO) with rigid internal fixation.Materials and MethodsThe maxilla was osteotomized using buccal access. Two parallel horizontal osteotomies were placed facially from the piriform aperture to the maxillary tuberosity. The inferior osteotomy was placed 5mm above the apices of the front teeth, whereas the superior osteotomy was placed below the floor of the nose. After the intrusion of the dento-alveolar segment with removal of horseshoe-shaped bone block, fixation with four titanium or resorbable miniplates was made.Method of Data AnalysisIn order to assess the postoperative maxillary movement pattern in 51 patients (mean age 23.1) with both vertical maxillary excess and so-called gummy smile, lateral cephalograms were obtained immediately preoperatively, and 1 day, 1 year, and 2 years after surgery. The changes in point A of the maxilla were examined on the cephalograms.ResultsNo apparent postoperative complications were found. At 1-year and 2-year follow-up, no significant postoperative relapse in the examined point of the maxilla was found in the horizontal (0.5±0.6 mm, 0.4±0.4 mm mean anterior movement, respectively) and vertical (0.2±0.4 mm, 0.2±0.4 mm mean anterior movement, respectively) direction.ConclusionThese results suggest that TMAO might be a reliable and useful technique for superior repositioning of the maxilla with alveolar height excess and gummy smile. Statement of the ProblemThe purpose of this study was to investigate the postoperative stability of the maxilla following the total maxillary alveolar osteotomy (TMAO) with rigid internal fixation. The purpose of this study was to investigate the postoperative stability of the maxilla following the total maxillary alveolar osteotomy (TMAO) with rigid internal fixation. Materials and MethodsThe maxilla was osteotomized using buccal access. Two parallel horizontal osteotomies were placed facially from the piriform aperture to the maxillary tuberosity. The inferior osteotomy was placed 5mm above the apices of the front teeth, whereas the superior osteotomy was placed below the floor of the nose. After the intrusion of the dento-alveolar segment with removal of horseshoe-shaped bone block, fixation with four titanium or resorbable miniplates was made. The maxilla was osteotomized using buccal access. Two parallel horizontal osteotomies were placed facially from the piriform aperture to the maxillary tuberosity. The inferior osteotomy was placed 5mm above the apices of the front teeth, whereas the superior osteotomy was placed below the floor of the nose. After the intrusion of the dento-alveolar segment with removal of horseshoe-shaped bone block, fixation with four titanium or resorbable miniplates was made. Method of Data AnalysisIn order to assess the postoperative maxillary movement pattern in 51 patients (mean age 23.1) with both vertical maxillary excess and so-called gummy smile, lateral cephalograms were obtained immediately preoperatively, and 1 day, 1 year, and 2 years after surgery. The changes in point A of the maxilla were examined on the cephalograms. In order to assess the postoperative maxillary movement pattern in 51 patients (mean age 23.1) with both vertical maxillary excess and so-called gummy smile, lateral cephalograms were obtained immediately preoperatively, and 1 day, 1 year, and 2 years after surgery. The changes in point A of the maxilla were examined on the cephalograms. ResultsNo apparent postoperative complications were found. At 1-year and 2-year follow-up, no significant postoperative relapse in the examined point of the maxilla was found in the horizontal (0.5±0.6 mm, 0.4±0.4 mm mean anterior movement, respectively) and vertical (0.2±0.4 mm, 0.2±0.4 mm mean anterior movement, respectively) direction. No apparent postoperative complications were found. At 1-year and 2-year follow-up, no significant postoperative relapse in the examined point of the maxilla was found in the horizontal (0.5±0.6 mm, 0.4±0.4 mm mean anterior movement, respectively) and vertical (0.2±0.4 mm, 0.2±0.4 mm mean anterior movement, respectively) direction. ConclusionThese results suggest that TMAO might be a reliable and useful technique for superior repositioning of the maxilla with alveolar height excess and gummy smile. These results suggest that TMAO might be a reliable and useful technique for superior repositioning of the maxilla with alveolar height excess and gummy smile.

A Review of 318 Odontogenic Tumors in Kaduna, Nigeria

To analyze 318 odontogenic tumors seen at a tertiary oral care center in Kaduna, Nigeria for comparison with findings in previous Nigerian and world records. A retrospective survey of odontogenic tumors based on the classification of Kramer et al was undertaken at the Maxillofacial Unit, Ahmadu Bello University Teaching Hospital, Kaduna, Nigeria, from all histopathologically proven cases of tumors and tumor-like lesions of the oral and perioral structures. Data were retrieved from case notes, radiographs, histopathology results, and follow-up records. Information collected were used to complete a questionnaire and subjected to analysis. There were 990 tumor and tumor-like lesions of the oral and perioral structures, of which 318 were odontogenic tumors (32%). Twelve histopathologic types of odontogenic tumors were found with more benign (n=314; 99%) than malignant (n=4; 1%). Ameloblastoma made up 233 (73%) of the tumors, followed by odontogenic myxoma (n=38; 12%), ameloblastic fibroma (n=9; 3%), and the adenomatoid odontogenic tumor (2%). Three cases of calcifying odontogenic cyst were co-existent with ameloblastoma (2) and ameloblastic fibro-odontoma (1). Among 275 surgically treated odontogenic tumors, enucleation was performed in 64 cases (23%), dentoalveolar segment resection with preservation of lower border of the mandible (n=33; 12%), segmental resection (n=168; 61%), and composite resection (n=9; 3%); 1 case was deemed inoperable. At least 8 cases of ameloblastoma (13%) recurred out of 60 followed up. Ameloblastoma is a fairly common tumor of Nigerian Africans accounting for 73% of odontogenic tumors and 24% of all tumors and tumor-like lesions of the oral and perioral structures. Various forms of resection are practiced to eradicate the tumor in view of the late presentation in our environment. Patients in Nigeria do not often return for follow-up reviews. A minimum of 5 years of follow-up reviews are necessary after treatment of ameloblastoma.

Treatment of an ankylosed central incisor by single tooth dento-osseous osteotomy and a simple distraction device

When teeth are replanted after being avulsed, the repair process sometimes results in ankylosis. In a growing child, the ankylosed tooth fails to move along with the remaining alveolar process during vertical growth, resulting in a tooth that gradually appears more and more impacted and requires several reconstructive procedures to correct. Ankylosed teeth can, however, serve as anchorage for orthodontic correction of a malocclusion and as a point of force application for a dentoalveolar segment during alveolar distraction osteogenesis. This case report describes the treatment of a 13-year-old girl whose maxillary left central incisor had been avulsed and replanted 5 years earlier. The tooth had become ankylosed, and it was used to provide "free anchorage" during distalization of the maxillary dentition. The underdeveloped alveolar process adjacent to the ankylosed tooth was reconstructed by dento-osseous segment distraction osteogenesis, by using the ankylosed tooth as the point of force application.

Surgical options in deep-bite mandibular deficiency with prominent chin – aesthetic considerations

Introduction: A deep-bite hypoplastic mandible associated with a strong chin poses an aesthetic challenge. Functional correction of the distal occlusion can bring the chin point beyond the ideal or normal profile line. The aim of the study was to outline the indications and drawbacks of four approaches that are currently used to deal with this problem. Material and Methods: A retrospective study was done using lateral cephalograms and pre- and postoperative pictures of 40 randomly selected patients, judged by a panel of four surgeons. The following parameters were studied apart from occlusion: A–P chin position, chin height, mentolabial and submental folds, cervicomental and gonial angles, antegonial notch, lower lip position, and anterior mandibular bowing. Results and Conclusion: Procedures that involve a setback of the chin are potentially prone to create or increase submental fullness, especially the mandibular advancement/chin setback osteotomy. Procedures involving advancement of the anterior dentoalveolar segment relative to the symphyseal prominence (e.g. mandibular advancement/chin setback osteotomy, dentoalveolar mandibular advancement osteotomy) are prone to flatten the mentolabial fold excessively. The position of the chin point after mandibular advancement–posterior rotation osteotomy is difficult to predict. Maxillomandibular posterior rotation has potentially the best aesthetic outcome, provided that the chin point is not set back.

Healing of maxillary alveolus in transport distraction osteogenesis for partial maxillectomy

Purpose This study aims to evaluate histologic healing of the new bone and soft tissue in the distraction gap of maxillary alveolus after transport distraction at different consolidation intervals. Materials and methods In a monkey model, dentoalveolar segment was distracted backward to a surgical defect in the posterior maxilla with an internal distractor at a rate of 1 mm/day for 2 weeks. The distracted dentoalveolar processes were harvested at 1, 2, and 3 months of consolidation after the completion of distraction. Histologic examination included the new bone, gingiva of the distraction gap, and teeth carrying the transport segments. Tartrate-resistant acid phosphatase was used to assess the presence of osteoclasts in the new bone. The collagen type and expression of bone morphogenetic proteins (BMPs) in the new bone were assessed by immunohistochemistry. Results The histology confirmed new bone bridging the distraction gap at 1 month of consolidation. Woven bone was progressively replaced by mature lamellar bone at the second and third months. The gingiva covering the distraction gap was of normal appearance. There were no pathologic pulpal changes noted in the transport segment. Tartrate-resistant acid phosphatase-positive osteoclasts were minimal in the new bone. The mode of ossification was confirmed as intramembranous, and the fibrous stroma consisted mainly of collagen type I. At 1 month of consolidation, the BMPs were expressed profusely in the fibrous matrix and also inside the fibroblasts and osteoblasts. At 2 and 3 months of consolidation, the BMP expression intensity was reduced significantly in the fibrous stroma. Conclusions The study confirmed that the bone regenerate in maxillary transport distraction was formed by intramembranous ossification and teeth in the transport segment remain viable after maxillary transport distraction osteogenesis.