Cleft patients frequently require a maxillary advancement surgery to correct the midface retrusion. The options are maxillary advancement by Le Fort osteotomy or distraction osteogenesis with external or intraoral devices. These treatments are not exempt of complications. One of the complications is the velopharyngeal insufficiency. According to the publications of Margaride and Liu, the technique of maxillary segmental distraction is an effective alternative to advance the maxilla, without altering the voice. It is also an excellent method for approximating segments of cleft patients unoperated of alveolar cleft. It also allows to get space for the location of teeth in the maxilla, which otherwise would not have space. In the studies of Liu and Margaride they use a Hyrax expansion device anchored to the teeth to distract. In this study we present a modification to the technique using intraoral distractors anchored to bone, allowing a skeletal advancement equivalent to the dental advancement associated with a reduced tendency to open bite. We present 2 cases of cleft patients segmental distraction. A 14 years old male with operated unilateral lip and palate cleft and a 19 years old woman with operated bilateral lip and palate cleft.
Segmentary distraction in cleft patients
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