Comparative study of different osteotomy modalities in maxillary distraction osteogenesis for cleft lip and palate.
Abstract
PURPOSE
Conventional maxillary distraction osteogenesis and anterior maxillary segmental distraction were applied in the treatment
of severe maxillary hypoplasia secondary to cleft clip and palate. The aim of the present study was to compare the difference
between these 2 osteotomy modalities used for rigid external distraction.
PATIENTS AND METHODS
Ten patients with severe maxillary hypoplasia secondary to CLP were enrolled in our study. They were randomly divided into
2 groups. Conventional maxillary distraction osteogenesis was performed in 5 patients and anterior maxillary segmental distraction
in 5 patients. The preoperative and postoperative lateral cephalograms were compared, and cephalometric analysis was performed.
The independent sample t test was used to evaluate the differences between the 2 groups.
RESULTS
All patients healed uneventfully, and the maxillae moved forward satisfactorily. The sella-nasion-point A angles, nasion-point
A-Frankfort horizontal plane angles, overjets, and 0-meridian to subnasale distances had increased significantly after distraction
osteogenesis. Significant differences were found in the changes in palatal length between the 2 groups (P < .05). A mean increase
of 7.50 mm in palatal length was found in the anterior maxillary segmental distraction group. No significant difference in
the changes in palatopharyngeal depth or soft palatal length was found.
CONCLUSIONS
With the ability of increasing the palatal and arch length, avoiding changes in palatopharyngeal depth, and preserving palatopharyngeal
closure function, anterior maxillary segmental distraction has great value in the treatment of maxillary hypoplasia secondary
to CLP. It is a promising and valuable technique in this potentially complicated procedure.
Links
Authors
Institution
Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China.
Source
Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons 70:11 2012 Nov pg 2641-7MeSH
AdolescentAdult
Cephalometry
Child
Cleft Lip
Cleft Palate
Female
Humans
Male
Maxilla
Maxillary Osteotomy
Osteogenesis, Distraction
Retrognathia
Young Adult
Pub Type(s)
Comparative StudyJournal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Language
eng
PubMed ID
22520568
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