Minimally invasive midface distraction for maxillary hypoplasia during growth

Introduction: Maxillary hypoplasia is very frequent in children with cleft lip and palate and results in difficult dental and orthodontic problems, jaw pain, sleep and breathing disturbances, and an imbalanced facial appearance. Patients with this problem traditionally need to undergo orthodontic treatment and orthognathic surgery. It has recently been shown that midface growth can be stimulated by distraction with temporary anchorage devices (TAD).

Objective: Prospective analysis of growth of the hypoplastic maxilla with orthodontic appliances including temporary anchorage devices (TAD) that are placed surgically on the maxilla and mandible. The goal of this pilot study is to obtain postoperative 3D imaging in patients who are undergoing this therapy at a standardized time point to quantify the growth in comparison with the preoperative imaging.

Patients and methods: Twenty participants are enrolled in the study, age >10 or ≤15 y, midface hypoplasia, treatment with TAD. Clinical examination and mini-CT scan pre- and 1 year postplacement of TAD, comparitive/descriptive data analysis of pre- and postoperative mini-CT.

Results: Minimally invasive distraction of the maxilla had few side effects. We recorded 2 plate loosening after 3–6 months and 1 plate breakage. All patients showed improvement of the class II skeletal and dental relationship.

Conclusions: Distraction of the maxilla during growth with TAD’s appears to be a safe and successful method to improve maxillary hypoplasia in children with cleft lip and palate.

Conflict of interest : None declared.

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Jan 27, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on Minimally invasive midface distraction for maxillary hypoplasia during growth
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