Postdistraction stability of hypoplastic maxilla in unilateral cleft lip and palate treated using rigid external distraction device: An audit

Abstract

Introduction: Maxillary hypoplasia resulting in skeletal class III malocclusion is common among patients with cleft lip and palate. Large anteroposterior discrepancies and surgical scaring often leads to unpredictable stability of maxillary advancement with Le Fort I osteotomy and is known for a high degree of relapse. The aim of this retrospective study was to evaluate the postdisraction stability after 1-year of maxillary advancement done with rigid external distraction (RED) device in patients with unilateral cleft lip and palate. Materials and Methods: Records of 11 cases treated with RED device used for distraction of maxilla in cleft lip and palate cases were assessed. Lateral cephalograms selected were taken at the end of presurgical (T1), immediate postdistraction (T2) and 1-year postdistraction (T3). Five angular measurements and nine linear measurements were used to assess the position of maxilla in all three planes. P values were obtained for repeated measurement by analysis of variance with Bonferroni's correction for multiple comparisons. Normality was tested using Shapiro-Wilk's test. Results: The average 1-year postdistraction measurements (T3) did not differ significantly compared to the corresponding average postdistraction measurements (T2) ( P > 0.05). Conclusion: Midface distraction with RED device provides a significant structural improvement for patients with cleft lip and palate. There was marked an improvement in dentofacial structures and results were stable during the retention phase.