Distraction osteogenesis and orthognathic surgery for a patient with unilateral cleft lip and palate.
Maxillary deficiency is a common feature in patients with repaired cleft lip and palate. Orthognathic surgery has been the conventional approach for the management of cleft-related maxillary hypoplasia. However, for patients with a severe maxillary deficiency, orthognathic surgery alone has many disadvantages, such as high relapse rates of 25% to 40%, instability, limited amount of advancement, and a highly invasive surgical technique. As an alternative treatment method, distraction osteogenesis has been used successfully in the distraction of the mandible, the maxilla, the entire midface, and the orbits as well as the cranial bones, with stable outcomes. The type of distraction device, either external or internal, can be chosen based on the surgical goals set for the patient. In this study, we report on the use of a rigid external distraction device for maxillary advancement in a 22-year-old woman with a repaired unilateral cleft lip and palate and severe maxillary hypoplasia. After the distraction osteogenesis, 2-jaw surgery was performed to correct the maxillary yaw deviation and the mandibular prognathism.
Resident, Department of Orthodontics, Hallym Sacred Heart Hospital, Anyang, Korea.
Ji Hyun
JH
Kim
Resident, Department of Orthodontics, Hallym Sacred Heart Hospital, Anyang, Korea.
Il Hong
IH
Lee
Assistant professor, Department of Orthodontics, School of dentistry, Dankook University, Cheonan, Korea.
Sang Min
SM
Lee
Associate professor, Department of Oral and Maxillofacial Surgery, Hallym Sacred Heart Hospital, Anyang, Korea.
Byoung Eun
BE
Yang
Clinical assistant professor, Department of Orthodontics, Hallym Sacred Heart Hospital, Anyang, Korea. Electronic address: purityp@hanmail.net.
In Young
IY
Park
D002508:Cephalometry / Q000379:methods; D002971:Cleft Lip / Q000601:surgery*; D002972:Cleft Palate / Q000601:surgery*; D016267:External Fixators; D005260:Female; D063172:Genioplasty / Q000379:methods; D006801:Humans; D008313:Malocclusion, Angle Class III / Q000601:surgery; D008437:Maxilla / Q000002:abnormalities* / Q000601:surgery; D056948:Orthognathic Surgical Procedures / Q000379:methods*; D019857:Osteogenesis, Distraction / Q000295:instrumentation / Q000379:methods*; D019340:Osteotomy, Le Fort / Q000379:methods; D059229:Osteotomy, Sagittal Split Ramus / Q000379:methods; D010347:Patient Care Planning; D011378:Prognathism / Q000601:surgery; D055815:Young Adult