scholarly journals Long-term stability after multidisciplinary treatment involving maxillary distraction osteogenesis, and sagittal split ramus osteotomy for unilateral cleft lip and palate with severe occlusal collapse and gingival recession: A case report

2019 ◽  
Vol 49 (1) ◽  
pp. 59
Author(s):  
Satoshi Kokai ◽  
Eiji Fukuyama ◽  
Susumu Omura ◽  
Sachiko Kimizuka ◽  
Ikuo Yonemitsu ◽  
...  
Keyword(s):  
Case Report ◽  
Distraction Osteogenesis ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Multidisciplinary Treatment ◽  
Gingival Recession ◽  
Sagittal Split Ramus Osteotomy ◽  
Long Term Stability ◽  
Maxillary Distraction

Treatment of Unilateral Cleft Lip and Palate Patient With Intraoral Tooth Tissue Borne Distractor and Facemask Therapy: A Case Report

2021 ◽  
pp. 105566562199336
Author(s):  
Akansha Bansal Agrawal ◽  
Harshavardhan Kidiyoor ◽  
Anand K. Patil Morth
Keyword(s):  
Case Report ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Face Mask ◽  
Rapid Maxillary Expansion ◽  
Growth Potential ◽  
Maxillary Expansion ◽  
Long Term Stability ◽  
Tooth Tissue

This case report demonstrates the successful use of intraoral distractor/hygenic rapid expander (HYRAX) for rapid maxillary expansion in anteroposterior direction with an adjunctive use of face mask therapy for anterior orthopedic traction of maxillary complex in a cleft patient with concave profile. The patient was a 13-year-old girl who reported with a chief complaint of backwardly positioned upper jaw and a severely forward positioned lower jaw. Therefore, a treatment was chosen in which acrylic bonded rapid maxillary expansion was done with tooth tissue borne intraoral distractor/HYRAX having a different activation schedule along with Dr Henri Petit facemask to treat maxillary retrognathism. As a result, crossbite got corrected and attained a positive jet with no bone loss in cleft area over a period of 5 months which was followed by fixed mechanotherapy achieving a well settled occlusion in 1 year. After completion of expansion and fixed mechanotherapy, ANB became +1 post-treatment which was −4 pretreatment. The prognathic profile was markedly improved by expansion and taking advantage of the remaining growth potential, thus minimizing the chances of surgery later in life. This provided a viable alternative to orthognathic surgery with good long-term stability.

Long-term Follow-up after Maxillary Distraction Osteogenesis in Growing Children with Cleft Lip and Palate

2007 ◽  
Vol 44 (3) ◽  
pp. 274-277 ◽  
Author(s):  
Chiung-Shing Huang ◽  
Pandurangan Harikrishnan ◽  
Yu-Fang Liao ◽  
Ellen W. C. Ko ◽  
Eric J. W. Liou ◽  
...  
Keyword(s):  
Distraction Osteogenesis ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
University Hospital ◽  
Anterior Nasal Spine ◽  
Distraction Device ◽  
Long Term Follow Up ◽  
The University ◽  
Maxillary Distraction

Objective: To evaluate the changes in maxillary position after maxillary distraction osteogenesis in six growing children with cleft lip and palate. Design: Retrospective, longitudinal study on maxillary changes at A point, anterior nasal spine, posterior nasal spine, central incisor, and first molar. Setting: The University Hospital Craniofacial Center. Main Outcome Measure: Cephalometric radiographs were used to measure the maxillary position immediately after distraction, at 6 months, and more than 1 year after distraction. Results: After maxillary distraction with a rigid external distraction device, the maxilla (A point) on average moved forward 9.7 mm and downward 3.5 mm immediately after distraction, moved backward 0.9 mm and upward 2.0 mm after 6 months postoperatively, and then moved further backward 2.3 mm and downward 6.8 mm after more than 1 year from the predistraction position. Conclusion: In most cases, maxilla moved forward at distraction and started to move backward until 1 year after distraction, but remained forward, as compared with predistraction position. Maxilla also moved downward during distraction and upward in 6 months, but started descending in 1 year. There also was no further forward growth of the maxilla after distraction in growing children with clefts.

One-Year Treatment Outcome of Profile Changes After Transcutaneous Maxillary Distraction Osteogenesis in Growing Children With Cleft Lip and Palate

2021 ◽  
pp. 105566562110056
Author(s):  
Wei-Ling Gao ◽  
Yi-Hao Lee ◽  
Chi-Yu Tsai ◽  
Te-Ju Wu ◽  
Jui-Pin Lai ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Distraction Osteogenesis ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Long Term Stability ◽  
Maxillary Advancement ◽  
Anterior Nasal Spine ◽  
Profile Changes ◽  
One Year

Objective: To evaluate the long-term stability of LeFort I osteotomy followed by distraction osteogenesis with a transcutaneous rigid external device for the treatment of severe maxillary hypoplasia in patients with cleft lip and palate. Patients and Methods: Nine patients with cleft lip and palate underwent rigid external distraction after a LeFort I osteotomy for maxillary advancement. Lateral cephalometric films were analyzed for assessment of treatment outcome and stability in 1 month, 6 months, and 1 year after distraction. Results: Significant maxillary advancement was observed in the horizontal direction, with the anterior nasal spine (ANS) distance of the maxilla increasing by an average of 20.5 ± 5.1 mm after distraction. The ANS relapse rates in 6 months and 1 year were 8.7% and 12.8%, respectively. The mean inclination of upper incisors to the palatal plane was almost unchanged (before: 109.8° ± 6.6°; after: 108.9° ± 7.5°). The movement ratios at the nasal tip/ANS, soft tissue A point/A point, and the upper vermilion border/upper incisor edge were 0.36:1, 0.72:1, and 0.83:1, respectively. Conclusion: Considerable maxillary advancement was achieved with less change of incisors inclination after distraction. Moreover, the relapse rate after 1 year was minimal. The concave facial profile was improved as well as the facial balance and aesthetics.

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