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CC BY-NC-ND 4.0 · Eur J Dent 2012; 06(02): 206-211
DOI: 10.1055/s-0039-1698952
Original Article
Dental Investigation Society

Maxillary protraction in adult cleft lip and palate by a rigid external distraction device with dentoskeletal anchorage

Bengisu Akarsu
1   Department of Orthodontics, Faculty of Dentistry, Hacettepe University, Ankara
,
Tulin Taner
1   Department of Orthodontics, Faculty of Dentistry, Hacettepe University, Ankara
,
Gokhan Tuncbilek
2   Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Hacettepe University
,
M. Emin Mavili
2   Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Hacettepe University
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Publikationsdatum:
11. März 2020 (online)

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ABSTRACT

Objective: The objective is to evaluate the effects of maxillary distraction osteogenesis (DO) in an adult patient with unilateral cleft lip and palate (UCLP) by using a rigid external distraction (RED) device with dentoskeletal anchorage.

Method: 31-year-old male patient with UCLP with severe maxillary hypoplasia, dolichofacial growth pattern, negative overjet and 1.5 mm openbite. After pre-surgical orthodontic treatment, an intra-oral appliance was modified to prevent extrusion of the molars and clockwise rotation of the mandible. Stainless steel plates were soldered bilaterally to the intra oral appliance at the level of canines. During surgery, miniplates were inserted in the maxillary segment and fixed to the plates of the intra oral appliance with screws.

Results: The mean distraction length was 12 mm immediately after DO. SNA increased from 73o to 82o after distraction. A significant advancement of the maxilla and correction of the sagittal Class III skeletal relationship was achieved. The vertical position of the mandible and the face was kept stable, and the soft tissue profile became more balanced.

Conclusion: This intra oral appliance design achieved desired skeletal changes during maxillary protraction with RED device in dolichofacial CLP patient. Occlusion and facial profile changes was found to be stable in 1-year follow-up. (Eur J Dent 2012;6:206-211)

Key words

Orthodontics; - cleft lip - external distraction
 

  • REFERENCES

  • 1 Polley JW, Figueroa AA. Rigid external distraction: its application in cleft maxillary deformities. Plast Reconstr Surg 1998;102:1360-1372.
  • 2 Kitai N, Kawasaki K, Yasuda Y, Kogo M, Murakami S, Kreiborg S, Takada K. Rigid external distraction osteogenesis for a patient with maxillary hypoplasia and oligodontia. Cleft Palate Craniofac J 2003;40:207-213.
  • 3 Welch TB. Stability in the correction of dentofacial deformities: a comprehensive review. J Oral Maxillofac Surg 1989;47:1142-1149.
  • 4 Harada K, Baba Y, Ohyama K, Omura K. Soft tissue profile changes of the midface in patients with cleft lip and palate following maxillary distraction osteogenesis: a preliminary study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002;94:673-677.
  • 5 Wen-Ching Ko E, Figueroa AA, Polley JW. Soft tissue profile changes after maxillary advancement with distraction osteogenesis by use of a rigid external distraction device: a 1-year follow-up. J Oral Maxillofac Surg 2000;58:959-969.
  • 6 De Clerck HJ, Cornelis MA, Cevidanes LH, Heymann GC, Tulloch CJ. Orthopedic traction of the maxilla with miniplates: a new perspective for treatment of midface deficiency. J Oral Maxillofac Surg 2009;67:2123-2129.
  • 7 Cornelis MA, Scheffler NR, Mahy P, Siciliano S, De Clerck HJ, Tulloch JF. Modified miniplates for temporary skeletal anchorage in orthodontics: placement and removal surgeries. J Oral Maxillofac Surg 2008;66:1439-1445.
  • 8 Minami K, Mori Y, Tae-Geon K, Shimizu H, Ohtani M, Yura Y. Maxillary distraction osteogenesis in cleft lip and palate patients with skeletal anchorage. Cleft Palate Craniofac J 2007;44:137-141.