A clinical evaluation of midface advancement using intraoral distractors in management of bone stock deficiencies

Abstract

BACKGROUNDCleft lip and palate patients present large osseous defects of the alveolus and midface hypoplasia. Traditional orthognathic surgery has limitations of relapse and limited age group. Distraction osteogenesis (DO) as a modality for midface advancement is relatively new. Modular internal distractor (MID) offers the advantage of patient compliance and minimal discomfort.The purpose of this study was to evaluate the versatility of intraoral distractors in midface advancement. METHODNineteen patients with midface bone stock deficiency were selected for maxillary advancement. At the first surgery under general anaesthesia, after the osteotomy (Le Fort I/II), MID system was used. After distraction, evaluation was done for ease of the procedure, stability, and complications.Lateral cephalograms were evaluated at three stages: T1, pre-distraction; T2, post-distraction; and T3, one year post-distraction. RESULTSSignificant changes showed 13.3 mm mean midface advancement bone formation at the pterygomaxillary region. The results were stable even at one year follow-up. CONCLUSIONMaxillary position improved in relation to the cranial base. This study showed that the MID was versatile in midface advancement in stability and patient compliance with minimal complications. MJAFI 2011;67:245-252