title: [An adjustable distractor for transverse maxillary distraction osteogenesis].
abstract: BACKGROUND
  The posterior skeletal widening in conventional distractions (Surgical Assisted Rapid Maxillary Expansion) is often modest, in contrast with a predominant anterior expansion. Until recently, it was not possible to consider transverse palatal distraction osteogenesis and Le Fort I impaction or advancement in the same procedure, as the osteosynthesis plates impeded maxillary anterior opening. We developed new sliding osteosynthesis plates allowing to perform an advancement or impaction Le Fort I osteotomy associated with a low-resistance bipartite palatal distraction osteogenesis. We had for aim to describe the device and to determine its clinical applications.
  
  
  METHODS
  This new palatal distractor is made up of two independent stainless steel jacks allowing for an adjustable distraction in the anterior or posterior area as needed. Bone-borne and tooth-borne versions are available.
  
  
  CONCLUSIONS
  This new distractor can be adjusted sagittally. The distraction can be angular or parallel, and the distraction mode can be modified during post-operative distraction. This device should be adapted to all clinical presentations. It can be used in combination with sliding osteosynthesis to perform a Le Fort 1 osteotomy and at the same time a complete correction of vertical, horizontal, and sagittal deficiencies.
authors.affiliation: Chirurgie maxillo-faciale et stomatologie, service de chirurgie plastique, reconstructrice et esthétique, centre hospitalier Robert-Ballanger, boulevard Robert-Ballanger, 93602 Aulnay-sous-Bois cedex, France.
authors.forename: P
authors.initials: P
authors.lastname: Leyder
authors.forename: G
authors.initials: G
authors.lastname: Wycisk
authors.forename: J
authors.initials: J
authors.lastname: Quilichini
mesh_terms: D001860:Bone Plates; D002508:Cephalometry; D004867:Equipment Design; D006801:Humans; D008437:Maxilla / Q000601:surgery*; D019857:Osteogenesis, Distraction / Q000295:instrumentation* / Q000379:methods; D019340:Osteotomy, Le Fort / Q000295:instrumentation / Q000379:methods; D010155:Palatal Expansion Technique / Q000295:instrumentation*; D010159:Palate / Q000601:surgery*