Limitations of Internal Distraction Devices in Mature Patients with Cleft Lip and Palate and Severe Midface Hypoplasia

Abstract

Purpose We evaluated case-sensitive limitations of internal distraction devices (IDDs) to reveal further options for satisfactory outcomes. Patients and Methods Two male cleft patients aged 22 years (P1) and 20 years (P2) with severe maxillary hypoplasia were treated over 18 months. Cephalometric analyses and analyses of A-point movements by superimposing lateral cephalograms were done before and after activation of IDDs and after bimaxillary surgery (BIMAX). Results After activating IDDs, the vectors deviated and clockwise rotation of the maxilla and vectors occurred. After 8 months, BIMAX was needed to carry out further maxillary advancement. Conclusions IDDs could pave the way to achieve maximal advancement with BIMAX in a second step and justify the overall treatment when comparing the initial situation with outcome.

Variación de la dimensión del espacio orofaringeo después de la cirugía de retroceso mandibular en pacientes con deformidad dentofacial clase III

“…Sin embargo, existen otros trabajos con resultados decepcionantes 10 , donde el distractor se muestra ineficaz para logar el avance deseado y conseguir convexidad facial y sobremordida.…”

Maxillary advancement in cleft palate patients with intraoral distraction

“…[7][8][9] However, there are other works with disappointing results, 10 where the distractor is shown to be ineffective to achieve the desired advancement and to achieve facial convexity and overbite. [7][8][9] However, there are other works with disappointing results, 10 where the distractor is shown to be ineffective to achieve the desired advancement and to achieve facial convexity and overbite.…”