title: A clinical evaluation of midface advancement using intraoral distractors in management of bone stock deficiencies.
abstract: BACKGROUND
  Cleft lip and palate patients present large osseous defects of the alveolus and midface hypoplasia. Traditional orthognathic surgery has limitations of relapse and limited age group. Distraction osteogenesis (DO) as a modality for midface advancement is relatively new. Modular internal distractor (MID) offers the advantage of patient compliance and minimal discomfort. The purpose of this study was to evaluate the versatility of intraoral distractors in midface advancement.
  
  
  METHODS
  Nineteen patients with midface bone stock deficiency were selected for maxillary advancement. At the first surgery under general anaesthesia, after the osteotomy (Le Fort I/II), MID system was used. After distraction, evaluation was done for ease of the procedure, stability, and complications. Lateral cephalograms were evaluated at three stages: T1, pre-distraction; T2, post-distraction; and T3, one year post-distraction.
  
  
  RESULTS
  Significant changes showed 13.3 mm mean midface advancement bone formation at the pterygomaxillary region. The results were stable even at one year follow-up.
  
  
  CONCLUSIONS
  Maxillary position improved in relation to the cranial base. This study showed that the MID was versatile in midface advancement in stability and patient compliance with minimal complications.
authors.affiliation: Professor and Vice Principal, Sri Sai Dental College, Vikarabad, Andhra Pradesh.
authors.forename: Ramen
authors.initials: R
authors.lastname: Sinha
authors.affiliation: Professor and HOD, Department of Oral and Maxillofacial Surgery, Vydehi Institute of Dental Sciences, Whitefield, Bangalore.
authors.forename: P Suresh
authors.initials: PS
authors.lastname: Menon
authors.affiliation: Graded Specialist, Oral and Maxillofacial Surgery, Mil Dental Centre, Base hospital, Delhi Cantt., New Delhi.
authors.forename: M G
authors.initials: MG
authors.lastname: Venugopal
keywords: distraction osteogenesis (DO); maxillary hypoplasia; midface advancement