Abstract
Orthognathic surgery and distraction osteogenesis play a prime role in the correction of maxillary hypoplasia in patients with cleft lip and palate (CLP). Advancement of the anterior maxilla alone without interfering with the velopharyngeal sphincter may be advantageous in cleft patients, who more commonly have speech deficits and dental crowding. We present a case series of anterior maxillary segmental distraction for maxillary hypoplasia in 5 CLP patients with a one-year follow-up. A custom-made tooth-borne distraction device with a hyrax screw positioned anteroposteriorly was used. The evaluation comprised of hard and soft tissue analysis and speech assessment. A stable occlusion with positive overjet and correction of dental-crowding without extraction was achieved at one year post-distraction. Facial profile and lip support improved. There was no deterioration in speech.
Highlights
Orthognathic surgery and distraction osteogenesis play a prime role in the correction of maxillary hypoplasia in patients with cleft lip and palate (CLP)
Of all patients born with cleft lip and/or palate (CLP), 25–60% require maxillary advancement to correct the maxillary hypoplasia and improve aesthetic facial proportions.[1]
A functionally stable occlusion with alignment of teeth in the arch and a positive overjet was established at the end of one year [Figure 2]
Summary
سانتو ش راو، بيو ش سوني، سيدراث جان، كي كيلو سكار، بي بنتو، جي لنجراج، أ س كوترا شيتي، سروثي راو. Abstract: Orthognathic surgery and distraction osteogenesis play a prime role in the correction of maxillary hypoplasia in patients with cleft lip and palate (CLP). We present a case series of anterior maxillary segmental distraction for maxillary hypoplasia in 5 CLP patients with a one-year follow-up. Of all patients born with cleft lip and/or palate (CLP), 25–60% require maxillary advancement to correct the maxillary hypoplasia and improve aesthetic facial proportions.[1] This can be accomplished with the help of orthognathic surgery or distraction osteogenesis, or both of these.[2] The first successful clinical application of anterior maxillary segmental distraction (AMSD) using an intraoral tooth-borne distractor on dogs was reported in 1994 by Block and Brister and on humans in 2003 by Dolanmaz.[3,4]. Subsequent clinical research was carried out to determine the optimal protocols for AMSD.[5,6,7,8,9,10] Here we present a series of five CLP cases treated with AMSD
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