title: Skeletal and soft tissue changes and stability in cleft lip and palate patients after distraction osteogenesis using a new intraoral maxillary device.
abstract: BACKGROUND
  The authors have recently reported on the use of an internal maxillary distraction device. In this study, we report on the hard and soft tissue movements achieved with this intraoral distraction device, and the stability changes after distraction osteogenesis for maxillary hypoplasia in patients with cleft lip and palate.
  
  
  METHODS
  Ten male patients with severe hypoplasia of the maxilla, with complete uni- or bilateral cleft lip and palate were included. The mean age of the patients at the time of operation was 11.91 years (±3.41). To evaluate the distraction process and stability, superimpositions on the preoperative lateral cephalograms were performed. The mean follow-up (FU) was 15.42 months (±3.94).
  
  
  RESULTS
  Cephalometric measurements at all of the maxillary hard and soft tissue points improved significantly. Maxillary point A was advanced by 8.25 mm (±3.17; P < 0.001). After distraction soft tissue point A' had advanced 7.10 mm (±2.69; P < 0.001). The soft tissue to hard tissue ratio at point A was 0.86:1 after distraction. Maxillary horizontal relapse at point A was 14.1% at FU. Vertical relapse was not significant.
  
  
  CONCLUSIONS
  This rigid intraoral distraction device can be successfully used in the correction of severe maxillary hypoplasia. The marked aesthetic improvement and low psychological encumbrance make this device viable for the treatment of cleft-related hypoplasia of the maxilla.
authors.affiliation: Department of Maxillofacial and Plastic Surgery, Necker Children's Hospital, AP-HP, Université Paris 5, Paris, France. Electronic address: eeam12@gmail.com.
authors.forename: Edward
authors.initials: E
authors.lastname: Ansari
authors.affiliation: Department of Maxillofacial and Plastic Surgery, Necker Children's Hospital, AP-HP, Université Paris 5, Paris, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Tomat
authors.affiliation: Department of Maxillofacial and Plastic Surgery, Necker Children's Hospital, AP-HP, Université Paris 5, Paris, France; Centre de Recherche des Cordeliers, INSERM, UMRS872, équipe 5, 75005 Paris, France.
authors.forename: Natacha
authors.initials: N
authors.lastname: Kadlub
authors.affiliation: Department of Maxillofacial and Plastic Surgery, Necker Children's Hospital, AP-HP, Université Paris 5, Paris, France.
authors.forename: Patrick A
authors.initials: PA
authors.lastname: Diner
authors.affiliation: Department of Maxillofacial and Plastic Surgery, Necker Children's Hospital, AP-HP, Université Paris 5, Paris, France.
authors.forename: Thomas
authors.initials: T
authors.lastname: Bellocq
authors.affiliation: Department of Maxillofacial and Plastic Surgery, Necker Children's Hospital, AP-HP, Université Paris 5, Paris, France; Centre de Recherche des Cordeliers, INSERM, UMRS872, équipe 5, 75005 Paris, France.
authors.forename: Marie-Paule
authors.initials: MP
authors.lastname: Vazquez
authors.affiliation: Department of Maxillofacial and Plastic Surgery, Necker Children's Hospital, AP-HP, Université Paris 5, Paris, France; Centre de Recherche des Cordeliers, INSERM, UMRS872, équipe 5, 75005 Paris, France.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Picard
mesh_terms: D000293:Adolescent; D059925:Anatomic Landmarks / Q000033:anatomy & histology; D001860:Bone Plates; D001864:Bone Wires; D002508:Cephalometry / Q000379:methods; D002648:Child; D002971:Cleft Lip / Q000601:surgery*; D002972:Cleft Palate / Q000601:surgery*; D004867:Equipment Design; D004954:Esthetics; D005145:Face / Q000033:anatomy & histology*; D005147:Facial Bones / Q000033:anatomy & histology*; D005500:Follow-Up Studies; D006801:Humans; D016268:Internal Fixators; D008297:Male; D008334:Mandible / Q000033:anatomy & histology; D008437:Maxilla / Q000002:abnormalities / Q000033:anatomy & histology / Q000601:surgery; D008904:Miniaturization; D009295:Nasal Bone / Q000033:anatomy & histology; D019857:Osteogenesis, Distraction / Q000295:instrumentation*; D012189:Retrospective Studies; D012658:Sella Turcica / Q000033:anatomy & histology; D055815:Young Adult
keywords: Hard tissue; Intraoral device; Maxillary distraction; Soft tissue; Stability