L’ostéosynthèse coulissante : une nouvelle technique de distraction transversale associée à une ostéotomie de Le Fort 1, d’avancée et/ou d’impaction

Abstract

The orthopedic and surgically assisted maxillary expansion is often followed by maxillary advancement osteotomy. The posterior width gain is often small. The expansion is often more extended anteriorly. It impairs posterior correction. The authors describe a new device, ensuring both transversal and sagittal maxillary correction in a single procedure. The sliding internal fixation device is in titanium, 0.8mm thick. It is made up of two plates (Deltex(®), Paris cedex 15, France): an inferior plate with a 45°-angulated slide, a superior plate with a spur. The surgical technique is a Le Fort 1 segmented osteotomy. The distractor is activated between the fifth and 10th postoperative day. Contention is maintained for 1 year after the end of activation. This sliding osteosynthesis technique allows stabilizing the advancement and/or impaction as well as transversal expansion for large transversal deficits in adult patients. This technique avoids performing a second procedure.