Maxillofacial intraoral distraction osteogenesis followed by elastic traction in cleft maxillary deformity.
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.
Lauwers
F
F
Department of Oral and Maxillofacial Surgery, Centre Hospitalier Universitaire de Toulouse, 31059 Toulouse, France. lauwers.f@chu-toulouse.fr
Mayorca-Guiliani
A
A
Lopez
R
R
Woisard-Bassols
V
V
Paoli
J-R
JR
Boutault
F
F
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