A Case of Unilateral Cleft Lip and Palate with Postoperative Skeletal Stability after Maxillary Distraction Osteogenesis

Abstract

This case report describes postoperative skeletal stability in a unilateral cleft lip and palate （UCLP） patient who received maxillary distraction osteogenesis （DOG） using a rigid extraoral distractor （RED） for maxillary advancement. The patient was a Japanese female with right UCLP who had presented at our orthodontic clinic at 5 years and 10 months of age. She received autologous secondary bone grafting （SBG） using cancellous bone from the iliac crest at 7 years and 6 months of age. Since the phase-1 orthodontic treatment to facilitate maxillary growth using a face mask did not work effectively, the objective of the phase-2 treatment was to correct midface hypoplasia. The maxilla was advanced by DOG using RED with a significant improvement of facial esthetics and skeletal relationship. By long-term face mask therapy for 9 months, there was little postoperative relapse of maxilla in this case. SBG and prolonged postsurgical face mask therapy are likely to improve postoperative skeletal stability in the sagittal dimension after maxillary DOG in CLP patients.cleft lip and palate, postoperative skeletal stability, maxillary distraction osteogenesis