Anterior maxillary distraction using tooth borne device for hypoplastic cleft maxillae—a pilot study

Introduction: Distraction for cleft retruded maxilla mostly involves movement of the whole maxilla at Le Fort I level and is characterized by higher relapse rate and hampering of speech. Hence we performed distraction of the anterior maxilla using a tooth borne palatal distractor similar to the one proposed by Gunaseelan et al. (2007). However, we modified the technique by placing the distractor pre-operatively. The main advantage of this is that more control over the vector can be achieved and chances of cement failure due to contamination and inability to achieve isolation is drastically reduced.

Aims and objectives: The study was aimed at studying the efficacy and stability of anterior maxillary distraction in management of cleft maxillary retrognathia and to study any complications thereof.

Materials and methods: Fourteen patients with cleft maxillary retrognathia above 12 years of age were included in the study irrespective of the sex, type of cleft lip and palate and amount of advancement needed. The patients were evaluated using OPG and lateral cephalograms pre-operatively, 3 months post-operatively and 6 months post-operatively. The distractor was fabricated extraorally on a cast and cemented into the patient’s mouth before surgery. The initial deficiency, amount of advancement achieved and relapses at 6 months if any were studied. The data was analysed.

Observations: Only one of the 14 cases showed relapse of 2 mm as the patient delayed the tooth replacement.

Conclusion: Anterior maxillary distraction with a tooth-borne device is a feasible modality for management of cleft maxillary retrognathia with stable results.

Conflict of interest: None declared.

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Jan 27, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on Anterior maxillary distraction using tooth borne device for hypoplastic cleft maxillae—a pilot study
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