title: Maxillofacial intraoral distraction osteogenesis followed by elastic traction in cleft maxillary deformity.
abstract: We present a case of severe maxillary hypoplasia in a 16 years old cleft patient treated by distraction osteogenesis maxillary advancement. Initial evaluation showed vertical and antero-posterior maxillary deficiencies, and a Class III malocclusion. Two intraoral distractors (Zurich Pediatric Maxillary Distractor, KLS Martin, Tuttlingen, Germany) were placed in a high Le Fort I osteotomy. An initial advancement of 11 mm was obtained, but the resulting occlusion was unsatisfactory (end-to-end occlusion). The consolidation period was reduced to 3 weeks to allow the mechanical manipulation of the newly formed bone with Class III elastics. An additional advancement of 3 mm, caused by elastic orthodontic traction produced both normal skeletal relationship and satisfactory occlusion. This observation shows that it is possible to carry on a skeletal maxillary displacement by interdental elastics before the complete fusion of the callus. After 12 months of postoperative follow-up no osseous relapse could be detected and the occlusal result was stable.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Centre Hospitalier Universitaire de Toulouse, 31059 Toulouse, France. lauwers.f@chu-toulouse.fr
authors.forename: F
authors.initials: F
authors.lastname: Lauwers
authors.forename: A
authors.initials: A
authors.lastname: Mayorca-Guiliani
authors.forename: R
authors.initials: R
authors.lastname: Lopez
authors.forename: V
authors.initials: V
authors.lastname: Woisard-Bassols
authors.forename: J-R
authors.initials: JR
authors.lastname: Paoli
authors.forename: F
authors.initials: F
authors.lastname: Boutault
mesh_terms: D000293:Adolescent; D002972:Cleft Palate / Q000150:complications*; D005115:Extraoral Traction Appliances; D005260:Female; D006801:Humans; D008313:Malocclusion, Angle Class III / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D008437:Maxilla / Q000601:surgery*; D008844:Micrognathism / Q000150:complications / Q000209:etiology / Q000601:surgery*; D019647:Oral Surgical Procedures / Q000379:methods*; D019857:Osteogenesis, Distraction; D019340:Osteotomy, Le Fort / Q000379:methods; D016896:Treatment Outcome