A retrospective analysis of complications associated with tooth-borne anterior maxillary distraction for managing cleft maxillary hypoplasia: A 12-year experience

Richardson, Sunil; Khandeparker, Rakshit Vijay Sinai

doi:10.1016/j.jcms.2020.02.014

Cited by 6 publications

(14 citation statements)

References 34 publications

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“…Specifically, with conventional Le Fort I there is an inadequate anterior advancement of the maxilla. Some of the advantages of AMDO as compared to Le Fort I are the advancement of the maxilla without speech being affected and increased maxillary length 3,4 . Although the mandibular position was not changed between T1 and T3 in this study, the maxilla advanced anteriorly, and not vertically, against the Frankfort Horizontal (FH).…”

Section: Discussionmentioning

confidence: 65%

“…A critical problem of avascular necrosis of the anterior segment was also reported in one case (0.2%). 3 The surgical technique of buccal bone-borne AMDO with a pre-bent distractor made with a 3D model for precise fixing, preventing root injury, and reducing operative time has been previously reported. In this study, an incisional line was made to maintain blood supply to the maxillary bone from the surrounding membrane.…”

Section: Discussionmentioning

confidence: 99%

“…16,24 In contrast the relapse rate after AMDO with tooth-borne distractor was reported 6.25%, 19.95%, and 21.2%. 3,6,8 After maxillary advancement with conventional Le Fort I in patients with CLP, the horizontal relapse at the A-point was reported as 20% to 40%, and vertical relapse was more than 50%. 25 In another report, the relapse rates after conventional Le Fort I advancement for the patients with CLP range from 22 to 40% in the horizontal plane and up to 70% in the vertical plane.…”

Section: Discussionmentioning

confidence: 99%

“…Most studies exploring AMDO have applied a tooth-borne distractor device. [3][4][5][6][7][8][9][10][11][12] However, bone-borne distraction devices do not often cause tooth movement or damage as tooth-borne distractors do. [13][14][15][16][17][18] This study aimed to evaluate the efficacy of distraction of bone-borne AMDO for the management of maxillary hypoplasia in CLP.…”

mentioning

confidence: 99%

“…Therefore advantages of AMDO include the advancement of the maxilla without speech being affected and with enlargement of maxillary length, unlike the similar procedure of Le Fort I advancement, and indication of AMDO is all maxillary hypoplasia in CLP. Most studies exploring AMDO have applied a tooth-borne distractor device 3–12 . However, bone-borne distraction devices do not often cause tooth movement or damage as tooth-borne distractors do 13–18 .…”

mentioning

confidence: 99%

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Anterior Maxillary Distraction Osteogenesis With Bone-borne Intraoral Buccal Devices for Maxillary Hypoplasia With Cleft Lip and Palate

Yamagata,

Mohri,

Watanabe

et al. 2023

Journal of Craniofacial Surgery

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Anterior maxillary distraction osteogenesis (AMDO) surgery for cleft lip and palate involves distraction of a segment of the anterior maxilla and advancement using 2 intraoral buccal bone-borne distraction devices. The anterior part of the maxilla is advanced anteriorly with less relapse which increases maxillary length and does not affect speech. We aimed to evaluate the effects of AMDO, including lateral cephalometric changes. Seventeen patients who had undergone this procedure were included in this retrospective study. The distractors were activated by 0.5 mm twice a day after a 3-day latency period. Lateral cephalometric radiographs were evaluated preoperatively, after distraction and removal of distractors, which were compared using the paired Student's t test. Anterior maxillary advancement was obtained in all patients with a median of 8.0 mm. Complications included nasal bleeding and loosening of distractors; however, there was no tooth damage or abnormal movement. The mean sella-nasion-A point (SNA) angle increased significantly, from 74.91°to 79.66°, the A pointnasion-B point angle from -0.38°to 4.34°, and the perpendicular line from nasion to Frankfort Horizontal (NV)-A point from -5.11 to 0.08 mm. The mean anterior nasal spine-posterior nasal spine length increased significantly from 50.74 to 55.10 mm, and the NV-Nose Tip from 23.59 to 26.27 mm. The mean relapse rate of NV-A was 11.1%. AMDO with bone-borne distractor resulted in less relapse and effectively corrected the maxillary retrusion.

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Section: Discussionmentioning

confidence: 65%

Section: Discussionmentioning

confidence: 99%