title: Long-term stability of LeFort III distraction osteogenesis with a rigid external distraction device in a patient with Crouzon syndrome.
abstract: A 6-year-old boy, diagnosed with Crouzon syndrome, had moderate exorbitism, a concave profile, an anterior crossbite of -4.0 mm, and a skeletal Class III jaw-base relationship caused by midfacial hypoplasia. At age 8 years 9 months, a LeFort III osteotomy was performed, and distraction osteogenesis was immediately started with the rigid external distractor system. The midface was advanced approximately 10.0 mm for 6 days, including overcorrection. After the distraction, a reverse headgear was used for 6 years to prevent relapse and to accelerate expected growth. At age 16 years 5 months, after extraction of the maxillary first premolars and mandibular third molars, 0.022-in preadjusted edgewise brackets were placed to treat the edge-to-edge incisor relationship and minor crowding. After 13 months of treatment, the facial profile was significantly improved, and an acceptable occlusion was achieved. During the 9-year observation period after the distraction, acceptable facial growth occurred, and no relapse of the maxillary advancement was observed. However, syndrome-specific growth and methodologically induced relapse should be considered when planning a LeFort III distraction in children for the treatment of Crouzon syndrome.
authors.affiliation: Department of Orthodontics and Dentofacial Orthopedics, University of Tokushima Graduate School of Oral Sciences, Tokushima, Japan. kuroda@dent.tokushima-u.ac.jp
authors.forename: Shingo
authors.initials: S
authors.lastname: Kuroda
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Watanabe
authors.forename: Kyoko
authors.initials: K
authors.lastname: Ishimoto
authors.forename: Hideki
authors.initials: H
authors.lastname: Nakanishi
authors.forename: Keiji
authors.initials: K
authors.lastname: Moriyama
authors.forename: Eiji
authors.initials: E
authors.lastname: Tanaka
mesh_terms: D001641:Bicuspid / Q000601:surgery; D002508:Cephalometry / Q000379:methods; D002648:Child; D003394:Craniofacial Dysostosis / Q000601:surgery*; D016267:External Fixators; D005115:Extraoral Traction Appliances; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008313:Malocclusion, Angle Class III / Q000601:surgery / Q000628:therapy; D008437:Maxilla / Q000601:surgery; D008445:Maxillofacial Development / Q000502:physiology; D008964:Molar, Third / Q000601:surgery; D016910:Orthodontic Brackets; D019857:Osteogenesis, Distraction / Q000295:instrumentation / Q000379:methods*; D019340:Osteotomy, Le Fort / Q000379:methods*; D010155:Palatal Expansion Technique / Q000295:instrumentation; D010347:Patient Care Planning; D012690:Serial Extraction; D014087:Tooth Movement Techniques / Q000295:instrumentation; D016896:Treatment Outcome