Management of Cleft Maxillary Hypoplasia with Anterior Maxillary Distraction: Our Experience

Abstract

Maxillary hypoplasia is a common developmental problem in cleft lip and palate deformities. Since 1970s these deformities have traditionally been corrected by means of orthognathic surgery. Management of skeletal deformities in the maxillofacial region has been an important challenge for maxillofacial surgeons and orthodontists. Distraction osteogenesis is a surgical technique that uses body's own repairing mechanisms for optimal reconstruction of the tissues. We present four cases of anterior maxillary distraction osteogenesis with tooth borne distraction device-Hyrax, which were analyzed retrospectively for the efficacy of the tooth borne device-Hyrax and skeletal stability of distracted anterior maxillary segment.

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

“…There are several types of distractors, including palatal bone-borne, palatal tooth-borne, and buccal bone-borne. Most studies of AMDO have applied palatal tooth-borne distractor devices 3–12 . Some reports of palatal bone-borne distractor devices do exist 21–23 .…”

“…Most studies of AMDO have applied palatal tooth-borne distractor devices. [3][4][5][6][7][8][9][10][11][12] Some reports of palatal bone-borne distractor devices do exist. [21][22][23] However, the application of bilateral buccal bone-borne devices was first reported by Karakasis et al in 2004.…”

“…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 .…”

“…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.…”