Comparison of internal versus external distraction osteogenesis of premaxilla for management of maxillary retrusion in cleft lip and palate patients

Objective: The premaxillary distraction osteogenesis was used for treatment of maxillary retrusion in cleft lip and palate patients. In this paper, we would like to compare the result of the pre-maxillary distraction osteogenesis with different fixation technique (intraoral, extraoral and hybrid method).

Materials and methods: 11 cleft lip and palate patients received premaxillary distraction osteogenesis were divided into 3 groups. The intraoral distraction were performed in 5 cases, the extraoral distraction were performed in 3 cases, and the combined intraoral and extraoral distraction were performed in 3 cases.

The surgical technique of the pre-maxillary distraction can be summarized as follows; firstly an maxillary anterior osteotomy was performed and immediately appliance was installed. Activation began following 7 days latency period, the activating protocol was 1 mm per day until obtaining good occlusal relation. After consolidation period 3 months the distractor was removed.

Cephalometric analysis were taken before treatment (T0), after distraction (T1), and after consolidation for 3 months (T2).

Result: Cephalometric analysis revealed that the pre-maxilla segment was moved forward and upward rotation, and inclination of the Mx1 was increased in the intraoral distraction.

But in the extraoral distraction pre-maxilla segment showed a tendency to move forward and downward rotation and inclination of the Mx1 was decreased.

In the hybrid method, the segment moved forward maintained the planed angulation.

Conclusion: In the premaxillary distraction osteogenesis for treatment of maxillary retrusion in cleft lip and palate patents, we could get the best result with hybrid(intraoral + extraoral) method.

Conflict of interest: None declared.

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Jan 27, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on Comparison of internal versus external distraction osteogenesis of premaxilla for management of maxillary retrusion in cleft lip and palate patients
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