DOI: http://dx.doi.org/10.18203/issn.2454-2156.IntJSciRep20192404

Maxillary distraction osteogenesis for correction of maxillary retrognathia in cleft lip and palate patients: a case series

Burçak Kaya, Secil Cubuk, Sıdıka Akdeniz, Burak Bayram

Abstract


The treatment protocol of patients having maxillary retrognatia is presented in this case series. Maxillary expansion, secondary alveolar bone grafting and/or oronasal fistula closure were performed in 6 cleft lip and palate patients. Preoperative simulation of Le Fort I osteotomy and adaptation of maxillary distractors were realized with stereolytographic cranium models. Intraoral maxillary distraction was applied under general anesthesia. A single unit acrylic occlusal splint was ligated to maxillary dental arch and worked as a guide during entire activation and consolidation period of distraction osteogenesis. Rigid internal fixation plates were placed in the osteotomy sites at the end of consolidation period. The amount of maxillary advancement was between 5-14 mm.  Satisfying occlusal and skeletal relationships were obtained in all patients. Advancement of maxilla by distraction osteogenesis resulted in gradual formation of bone at the osteotomy line and enhanced treatment outcome in patients with cleft lip and palate.


Keywords


Cleft lip palate, Maxillary retrognathia, Distraction osteogenesis, Orthodontics

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References


Chua HD, Hägg MB, Cheung LK. Cleft maxillary distraction versus orthognathic surgery: which one is more stable in 5 years? Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;109(6):803-4.

Saltaji H, Major AP, Alfakir H, Al- Saleh MA, Flores-Mir C. Maxillary advancement with conventional orthognathic surgery in patients with cleft lip and palate: is it a stable technique? J Oral Maxillofac Surg. 2012;70(12):2859-66.

Saltaji H, Major MP, Altalibi M, Youssef M, Flores- Mir C. Long-term stability after maxillary advancement with distraction osteogenesis in cleft lip and palate patients. Angle Orthod. 2012;82(69):1115-22.

Linton JL. Comparative study of diagnostic measures in borderline surgical cases of unilateral cleft lip and palate and noncleft Class III malocclusions. Am J Orth Dent Orth. 1998;113(5):526-37.

Meazzini MC, Basile V, Mazzoleni F, Bozzetti A, Brusati R. Long-term follow-up of large maxillary advancements with distraction osteogenesis in growing and non-growing cleft lip and palate patients. J Plast Reconstr Aesthet Surg. 2015;68(1):79-86.

Drew SJ. Clinical controversies in oral and maxillofacial surgery: part one. Maxillary distraction osteogenesis for advancement in cleft patients, internal devices. J Oral Maxillofac Surg. 2008;66(12):2592-7.

Tabrizi R, Tumer K, Shafiei S, Rashad A. Can use of rigid fixation after consolidation increase stability in cleft patients following distraction osteogenesis? J Oral Maxillofac Surg. 2018;76(6):1309-15.