SS  Vol.6 No.2 , February 2015
Maxillary Distraction Osteogenesis
ABSTRACT

Background: Distraction Osteogenesis is popular for long bones. And nowadays it has found its role in facial bone deficiency treatments. Purpose: We used our special designed Distractor for advancement of Maxillary deficiencies in cleft lip and palate patients. The purpose of this paper is to compare the treatment of hypoplastic, posteriorly retruded maxillary of cleft palate patients using distraction osteogenesis vs. Le fort I orthognathic surgery for length of advancement, stability and relapse, growth after distraction and soft tissue expansion and soft tissue profile changes. Meterial & Methods: In group A only Le fort I and surgical maxillary advancement sometimes with bone graft were done. In group B we used our special Distractor for Distraction Osteogenesis and advancement of the Maxillary bone. Demographic data, length of retrusion of maxilla, time length of treatment, length of advancement and relapse, SNA and SNB angles were measured and included in the study. The results were compared in each group before and after advancement and between both groups. The rate of distraction was 0.5 mm twice per day to achieve normal occlusion with 2 mm overcorrection more than calculated measures. The devices removed after 10 weeks as latency period. Results: The SNA increased at the end of distraction (p < 0.001), with no significant relapse indicating stability at 1 year after treatment. The total length of advancement in group A was 17 ± 4 mm and in group B was 20 ± 3 mm. The difference between before and after measurements in each group was significant (p = 0.002, p = 0.003 respectively). The mean length of relapse in group A was 3 ± 1 mm and in group B was 1 mm. Discussion: For the deformities and retrusions less than 7 - 8 mm, the Orthognatic surgery is the treatment of choice, however for more retrusions (>10 mm) we recommend Distraction Osteogenesis, and it preferred to start it soon in younger ages.


Cite this paper
Hassani, M. , Karimi, H. , Hassani, H. and Hassani, A. (2015) Maxillary Distraction Osteogenesis. Surgical Science, 6, 13-21. doi: 10.4236/ss.2015.62003.
References
[1]   Schendel, S.A., Hazan-Molina, H. and Aizenbud, D. (2014) Combined Orthognathic Distraction Procedure: Le Fort I Maxillary Osteotomy and Mandibular Curvilinear Distraction Osteogenesis. A New Technique for Craniofacial Management. Plastic and Reconstructive Surgery, 133, 874-877.
http://dx.doi.org/10.1097/PRS.0000000000000055

[2]   Natu, S.S., Ali, I., Alam, S., Giri, K.Y., Agarwal, A. and Kulkarni, V.A. (2014) The Biology of Distraction Osteogenesis for Correction of Mandibular and Craniomaxillofacial Defects: A Review. Dental Research Journal (Isfahan), 11, 16-26.

[3]   Lucchese, A., Gherlone, E.F., Asperio, P. and Baena, R.R. (2014) The Distraction Osteogenesis in Midfacial Hypoplasia. Journal of Craniofacial Surgery, 25, 831-834.
http://dx.doi.org/10.1097/SCS.0000000000000738

[4]   Rachmiel, A., Even-Almos, M. and Aizenbud, D. (2012) Treatment of Maxillary Cleft Palate: Distraction Osteogenesis vs. Orthognathic Surgery. Annals of Maxillofacial Surgery, 2, 127-130.
http://dx.doi.org/10.4103/2231-0746.101336

[5]   Corega, C., Vaida, L., Festila, D.G., Rigoni, G., Albanese, M., D’Agostino, A., Chiarini, G., Nocini, P.F. and Bertossi, D. (2014) Bimaxillary Distraction Osteogenesis Used for Treatment of Crowding in Non-Growing Individuals. Case Report. Minerva Stomatologica.

[6]   Kim, B.C., Lee, S.H., Park, K.R., Jung, Y.S. and Yi, C.K. (2014) Reconstruction of the Premaxilla by Segmental Distraction Osteogenesis for Maxillary Retrusion in Cleft Lip and Palate. The Cleft Palate-Craniofacial Journal, 51, 240-245. http://dx.doi.org/10.1597/12-265

[7]   Neelakandan, R.S. and Bhargava, D. (2012) Transport Distraction Osteogenesis for Maxillomandibular Reconstruction: Current Concepts and Applications. Journal of Maxillofacial and Oral Surgery, 11, 291-299. http://dx.doi.org/10.1007/s12663-011-0329-3

[8]   Metzler, P., Geiger, E.J., Chang, C.C. and Steinbacher, D.M. (2014) Surgically Assisted Maxillary Expansion Imparts Three-Dimensional Nasal Change. Journal of Oral and Maxillofacial Surgery, 72, 2005-2014. http://dx.doi.org/10.1016/j.joms.2014.03.004

[9]   Ghasemianpour, M., Ehsani, S., Tahmasbi, S., Bayat, M., Ghorbanpour, M., Safavi, S.M. and Mirhashemi, F.S. (2014) Distraction Osteogenesis for Cleft Palate Closure: A Finite Element Analysis. Dental Research Journal (Isfahan), 11, 92-99.

[10]   Doucet, J.C., Herlin, C., Bigorre, M., Baumler, C., Subsol, G. and Captier, G. (2014) Mandibular Effects of Maxillary Distraction Osteogenesis in Cleft Lip and Palate. International Journal of Oral & Maxillofacial Surgery, 43, 702-707. http://dx.doi.org/10.1016/j.ijom.2014.01.017

[11]   Rattan, V., Jena, A.K., Singh, S.P. and Utreja, A.K. (2014) Maxillary Distraction Osteogenesis at Le Fort-I Level Induces Bone Apposition at Infraorbital Rim. Clinical Oral Investigations, 18, 1741-1748. http://dx.doi.org/10.1007/s00784-013-1149-2

[12]   Sant’Anna, E.F., Cury-Saramago, A.A., Lau, G.W., Polley, J.W. and Figueroa, á.A. (2013) Treatment of Midfacial Hypoplasia in Syndromic and Cleft Lip and Palate Patients by Means of a Rigid External Distractor (RED). Dental Press Journal of Orthodontics, 18, 134-143.
http://dx.doi.org/10.1590/S2176-94512013000400005

[13]   Rao Janardhan, S., Kotrashetti, S.M., Lingaraj, J.B., Pinto, P.X., Keluskar, K.M., Jain, S., Sone, P. and Rao, S. (2013) Anterior Segmental Distraction Osteogenesis in the Hypoplastic Cleft Maxilla: Report of Five Cases. Sultan Qaboos University Medical Journal, 13, 454-459.

[14]   Doucet, J.C., Herlin, C., Bigorre, M., B?umler, C., Subsol, G. and Captier, G. (2013) Effects of Growth on Maxillary Distraction Osteogenesis in Cleft Lip and Palate. Journal of Cranio-Maxillo-Facial Surgery, 41, 836-841. http://dx.doi.org/10.1016/j.jcms.2013.01.038

[15]   Rachmiel, A., Even-Almos, M. and Aizenbud, D. (2012) Treatment of Maxillary Cleft Palate: Distraction Osteogenesis vs. Orthognathic Surgery. Annals of Maxillofacial Surgery, 2, 127-130.
http://dx.doi.org/10.4103/2231-0746.101336

 
 
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