title: Treatment of a patient with cleft lip and palate using an internal distraction device.
abstract: A 24-year-old man with a bilateral cleft lip and palate was treated by a multidisciplinary team composed of an orthodontist, plastic surgeon, and prosthodontist with assistance from an engineer. Before treatment, clinical photographs, dental casts, lateral and posteroanterior cephalograms, periapical and panoramic radiographs, and three-dimensional computed tomography (3D CT) images were obtained. He presented with a narrow and retrognathic maxilla with a 23-mm anterior open bite. Following maxillary expansion with rapid palatal expansion, a Le Fort I maxillary osteotomy was performed, and an internal distractor was placed. After a 5-day latency period, internal maxillary distraction was performed at a rate of 1 mm/day achieved by two activations per day. Cephalometric analysis showed a 7-mm maxillary advancement. Mandibular bilateral sagittal split osteotomy was also performed to close the open bite following maxillary distraction and a 3-month stabilization period. Finally, the treatment was completed with prosthetic rehabilitation. The changes in speech production were evaluated using an automatic speech recognition system.
authors.affiliation: Orthodontist, Kasimpasa Military Hospital, Istanbul, Turkey. emel_sari@yahoo.com
authors.forename: Emel
authors.initials: E
authors.lastname: Sari
authors.forename: Cihan
authors.initials: C
authors.lastname: Ucar
authors.forename: Oytun
authors.initials: O
authors.lastname: Türk
authors.forename: Huseyin
authors.initials: H
authors.lastname: Kurtulmus
authors.forename: H Ayberk
authors.initials: HA
authors.lastname: Altug
authors.forename: Suheyl
authors.initials: S
authors.lastname: Pocan
mesh_terms: D002508:Cephalometry; D002971:Cleft Lip / Q000601:surgery*; D002972:Cleft Palate / Q000601:surgery*; D003828:Denture, Overlay; D006801:Humans; D021621:Imaging, Three-Dimensional; D016268:Internal Fixators; D008297:Male; D008334:Mandible / Q000601:surgery; D008437:Maxilla / Q000601:surgery; D003765:Models, Dental; D024343:Open Bite / Q000601:surgery; D019857:Osteogenesis, Distraction / Q000295:instrumentation*; D019340:Osteotomy, Le Fort; D010155:Palatal Expansion Technique; D010348:Patient Care Team; D023861:Photography, Dental; D016300:Radiography, Bitewing; D011862:Radiography, Panoramic; D063173:Retrognathia / Q000601:surgery; D014057:Tomography, X-Ray Computed; D055815:Young Adult