[Distraction osteogenesis for the premaxillary reconstruction. Report of 3 cases].
Reconstructing the premaxillary is well-known for being difficult and usually requires a bone implant, in grafts or flaps. This technique has a high morbidity rate and its middle or long term results remain uncertain. Thanks to their experience and to the results they achieved in mandible and maxillary osteogenic distraction, the authors suggest applying the principle of distraction osteogenesis to the premaxillary reconstruction. Three patients have been treated: first, two hypoplasias of the premaxillary, sequelae of a cleft palate and of a former traumatic loss of teeth; secondly one premaxillary defect following a gunshot wound. The first two were women, the other one was man, all adults. For premaxillary distraction, an intraoral extramucosa device is made-up for each individual case before the surgical operation itself and after an orthognathic analysis. The surgical operation consists in a classical segmental maxillary osteotomy which respects the palatal periosteum, and also in fitting a distractor device with transmucosa screws into the palatal bone. In each of the three cases, with a follow-up from 24 to four months, the reconstruction of the premaxillary by distraction osteogenesis is considered satisfactory and stable as regards both bone and soft tissues. This achieves particularly a very good expansion of the fibrous mucosa of the palate which makes it possible to re-insert false teeth, with or without implants into the bone. The principle of distraction osteogenesis applied to premaxillary reconstruction has shown, in our cases, very good functional and aesthetic results. Yet the techniques we used are simple and have a low morbidity rate; secondly the distraction device is easy to design and little expansive.
Kaluzinski
E
E
Service de chirurgie maxillofaciale, CH Louis Pasteur, 50100 Cherbourg, France. ekalu@wanadoo.fr
Bénateau
H
H
Labbé
D
D
Mundreuil
M
M
D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008437:Maxilla / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D019857:Osteogenesis, Distraction / Q000379:methods*; D011859:Radiography; D019651:Plastic Surgery Procedures / Q000379:methods
Reconstruction du prémaxillaire par distraction ostéogénique. A propos de trois cas cliniques.