title: Rotational movement of the anterior maxillary segment by hybrid distractor in patients with cleft lip and palate.
abstract: OBJECTIVE
  Maxillary anterior segmental distraction osteogenesis (MASDO) is an effective surgical orthodontic treatment for the retruded maxilla in cleft lip and palate because of its benefit of the conservation of velopharyngeal function. Some reports showed MASDO using various devices, but they do not allow the rotational movement of the distracted anterior segment. In this article, we showed MASDO using hybrid distracters (DynaForm System: Stryker Osteosymthesis, Leibinger Micro Implants, Kalamazoo, MI), which allow the advance of the distracted segment with rotational movement.
  
  
  METHODS
  The hybrid distractor with 4 metal arms is secured beyond both alveolar osteotomy lines on each side. These 2 distractors permit rotational movement of the segment by controlling the amount of advancement on each side.
  
  
  RESULTS
  For 6 patients with cleft lip and palate, MASDO using hybrid distractors was performed and the anterior segment moved at planned positions without any complications except lip discomfort, which disappeared after removal of the distractor.
  
  
  CONCLUSIONS
  MASDO, using an institutionally diagnosed hybrid distractor can successfully achieve the necessary rotational movements of the anterior maxillary segment owing to its design, which incorporates some mechanical flexibility.
authors.affiliation: The First Department of Oral and Maxillofacial Surgery, Osaka University Graduate School of Dentistry, Osaka, Japan.
authors.forename: Tomonao
authors.initials: T
authors.lastname: Aikawa
authors.forename: Seiji
authors.initials: S
authors.lastname: Haraguchi
authors.forename: Susumu
authors.initials: S
authors.lastname: Tanaka
authors.forename: Setsuko
authors.initials: S
authors.lastname: Uematsu
authors.forename: Miki
authors.initials: M
authors.lastname: Ishibashi
authors.forename: Mikihiko
authors.initials: M
authors.lastname: Kogo
authors.forename: Seiji
authors.initials: S
authors.lastname: Iida
mesh_terms: D000293:Adolescent; D002971:Cleft Lip / Q000150:complications / Q000601:surgery*; D002972:Cleft Palate / Q000150:complications / Q000601:surgery*; D004867:Equipment Design; D005260:Female; D006801:Humans; D019248:Jaw Fixation Techniques / Q000295:instrumentation; D008297:Male; D008310:Malocclusion / Q000209:etiology / Q000601:surgery; D008437:Maxilla / Q000002:abnormalities / Q000601:surgery*; D009971:Orthodontics, Corrective / Q000379:methods; D056948:Orthognathic Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D019857:Osteogenesis, Distraction / Q000295:instrumentation* / Q000379:methods; D012399:Rotation; D055815:Young Adult