Indications A too narrow lower jaw is usually accompanied by a too narrow upper jaw, creating problems such as tooth crowding, chewing deficiency, and un-aesthetic buccal corridors upon smiling. Tooth extractions can make place for the remaining teeth, but may lead to a dished-in, prematurely aged face. A smile showing a wide dental arch, with little space between the cheek and the teeth, is more attractive. “Trans Mandibular Distraction” is a technique by which the lower jaw is surgically splitted in the midline area and widened by an expansion device that is fixed on the chin bone. It is exposed between the lower lip and the front teeth. The jaw regains its initial strength after consolidation of the widened segment. The space that is created between the incisors is used to correct the transversal deficiency and to achieve the teeth alignment. “Trans Mandibular distraction” is most frequently accompanied by “Trans Palatal Distraction”. It is recommended to inform the patient that a space between the incisors will occur. (Between 4mm and 10mm). After bone regeneration, due to distraction Osteogenesis, all teeth will be gently aligned by orthodontic treatment.