Maxillary distraction osteogenesis in the adolescent cleft patient: three-dimensional computed tomography analysis of linear and volumetric changes over five years.
OBJECTIVE
To assess the results of maxillary distraction osteogenesis with the Rigid External Distraction System using three-dimensional computed tomography scan volume-rendered images with respect to stability and facial growth at three time frames: preoperative (T0), 1-year postoperative (T1), and 5-years postoperative (T2).


METHODS
Retrospective analysis.


METHODS
Tertiary.


METHODS
A total of 12 patients with severe cleft maxillary hypoplasia were treated between June 30, 1997, and July 15, 1998. The mean age at surgery was 11 years 1 month.


METHODS
Le Fort I maxillary distraction osteogenesis. Distraction was started 2 to 5 days postsurgery at a rate of 1 mm per day. The consolidation period was 3 months. No face mask was used. A paired t test was used for statistical analysis.


METHODS
Overjet, ANB, and SNA and maxillary, pterygoid, and mandibular volumes.


RESULTS
From T0 to T1, there were statistically significant increments of overjet, ANB, and SNA and maxillary, pterygoid, and mandibular volumes. The T1 to T2 period demonstrated a reduction of overjet (30.07%) and ANB (54.42%). The maxilla showed a stable SNA and a small but statistically significant advancement of the ANS point. There was a significant increase in the mandibular volume. However, there was no significant change in the maxillary and pterygoid volumes.


CONCLUSIONS
Maxillary distraction osteogenesis demonstrated linear and volumetric maxillary growth during the distraction phase without clinically significant continued growth thereafter. Overcorrection is required to take into account recurrence of midface retrusion over the long term.
Philip Kuo-Ting
PK
Chen
Yong-Chen
YC
Por
Eric Jein-Wein
EJ
Liou
Frank Chun-Shin
FC
Chang
D000293:Adolescent; D002508:Cephalometry / Q000379:methods; D002648:Child; D002972:Cleft Palate / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008137:Longitudinal Studies; D008297:Male; D008313:Malocclusion, Angle Class III / Q000601:surgery; D008334:Mandible / Q000473:pathology; D008437:Maxilla / Q000002:abnormalities / Q000473:pathology / Q000601:surgery*; D008445:Maxillofacial Development / Q000502:physiology; D009295:Nasal Bone / Q000473:pathology; D019857:Osteogenesis, Distraction / Q000379:methods*; D019340:Osteotomy, Le Fort / Q000379:methods; D057887:Overbite / Q000473:pathology; D010347:Patient Care Planning; D012008:Recurrence; D012189:Retrospective Studies; D012658:Sella Turcica / Q000473:pathology; D013100:Sphenoid Bone / Q000473:pathology; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014584:User-Computer Interface