title: Midfacial Changes Through Anterior Maxillary Distraction Osteogenesis in Patients With Cleft Lip and Palate.
abstract: Maxillary hypoplasia is a major issue in cleft lip and palate patients, and predictable surgical maxillary advancement is required. In the present study, the changes and stability of the maxilla and soft tissue profile achieved after the application of anterior maxillary distraction osteogenesis (AMDO) using intraoral expander in unilateral cleft lip and palate and isolated cleft palate patients were investigated by comparing to the Le Fort I osteotomy (LFI) and maxillary distraction osteogenesis (DO) with rigid external distraction (RED) system.Ten patients who underwent orthognathic treatment with AMDO were examined (AMDO group). Changes in the positions of soft and hard tissue landmarks were calculated from the lateral cephalograms taken before the distraction, at the end of the distraction, and 1 year after the surgery. They were compared with the changes in 7 other unilateral cleft lip and palate patients who underwent LFI (LFI group) and 6 others who underwent DO with RED (RED group).The mean maxillary advancement of the AMDO group was similar to that of the RED group, judged by the change of point A. During DO, the AMDO group showed less clockwise rotation of mandible compared to the RED group. The soft tissue advancement of the upper lip and nose in the AMDO group was similar to that in the RED group, which was significantly larger than that in the LFI group.Our results indicate that AMDO can be surgical option to cleft lip and palate patients with less invasive but excellent improvement in both midfacial skeletal and soft tissue similar to DO-RED.
authors.affiliation: *Tohoku University Hospital, Maxillo-Oral Disorders, Sendai †Department of Orthodontics, School of Dental Medicine, Tsurumi University, Yokohama ‡Department of Oral Dysfunction Science, Tohoku University Graduate School of Dentistry §Department of Plastic and Reconstructive Surgery, Tohoku University Graduate School of Medicine ||Tsutsujigaoka Dental Clinic, Sendai, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kanzaki
authors.forename: Yoshimichi
authors.initials: Y
authors.lastname: Imai
authors.forename: Tetsu
authors.initials: T
authors.lastname: Nakajo
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Daimaruya
authors.forename: Akimitsu
authors.initials: A
authors.lastname: Sato
authors.forename: Masahiro
authors.initials: M
authors.lastname: Tachi
authors.forename: Youhei
authors.initials: Y
authors.lastname: Nunomura
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Itagaki
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Nishimura
authors.forename: Shoko
authors.initials: S
authors.lastname: Kochi
authors.forename: Kaoru
authors.initials: K
authors.lastname: Igarashi
mesh_terms: D000293:Adolescent; D000328:Adult; D002508:Cephalometry; D002971:Cleft Lip / Q000601:surgery*; D002972:Cleft Palate / Q000601:surgery*; D005260:Female; D006801:Humans; D008046:Lip; D008297:Male; D008334:Mandible; D008437:Maxilla / Q000601:surgery*; D009666:Nose; D019857:Osteogenesis, Distraction / Q000379:methods*; D019340:Osteotomy, Le Fort / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult