Treatment of midfacial hypoplasia in syndromic and cleft lip and palate patients by means of a rigid external distractor (RED)

Sant’Anna, Eduardo Franzotti; Cury-Saramago, Adriana de Alcântara; Lau, Geórgia Wain Thi; Polley, John W.; Figueroa, Álvaro A.

doi:10.1590/s2176-94512013000400005

Cited by 7 publications

(6 citation statements)

References 33 publications

(31 reference statements)

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“…This approach provides predictable and stable results [12]. This results are the same as ours and proved efficacy of this method.…”

Section: Discussionsupporting

confidence: 86%

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Maxillary Distraction Osteogenesis

Hassani¹,

Karimi²,

Hassani³

et al. 2015

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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.

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“…This approach provides predictable and stable results [12]. This results are the same as ours and proved efficacy of this method.…”

Section: Discussionsupporting

confidence: 86%

“…Also in tumors abalation one can use transport DO [12]. Janardhan reported that Advancement of the anterior maxilla alone without interfering with the velopharyngeal sphincter may be advantageous in cleft patients, who more commonly have speech deficits and dental crowding.…”

Section: Discussionmentioning

confidence: 99%

Maxillary Distraction Osteogenesis

Hassani¹,

Karimi²,

Hassani³

et al. 2015

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“…This is similar to the method used by Engel et al (2019) in their study and by Kuroda et al (2011) in their case. The distraction protocol used was in accordance with the generally advocated activation range of 1-2 mm a day till the skeletal deformity is corrected (Sant'Anna et al, 2013). The RED device is a titanium-based frame with ease of control of vector of distraction (Satoh et al, 2003) and its removal in adults is easier as it can be done without anaesthesia.…”

Section: Discussionmentioning

confidence: 99%

Comprehensive management of Crouzon syndrome: A case report with three-year follow-up

et al. 2021

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Crouzon syndrome is one of the most common craniosynostosis facial syndromes caused by a mutation in the fibroblast growth factor receptor 2 (FGFR2) gene. Less commonly, there is a mutation of the FGFR3 gene which results in Crouzon syndrome syndrome with acanthosis nigricans. It involves the premature fusion of sutures of the cranial vault, base, orbital and maxillary region. The clinical presentation of this congenital deformity depends on the pattern and timing of sutural fusion. The present report describes the features and management of this syndrome in an 18-year-old woman. The patient presented with a hypoplastic maxilla, deficient midface, exorbitism due to shallow orbits, severe crowding and bilateral crossbite. A multidisciplinary approach involving orthodontics and surgical intervention with distraction osteogenesis brought about marked improvement in the facial profile, occlusion and upper airway. The aesthetics and function were greatly enhanced, and the results were found to be stable at the end of three years.

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“…Thus, based on that experience, we decided that we needed a distractor that was not submerged underneath the skin for application. 6 Dr. John Polley had experience with neurosurgery, particularly with putting on neurosurgery halos and removing them, as he did during his general surgical rotations, and I was very familiar with the use of the protraction orthodontic face mask. Therefore, we thought about using an external halo as an anchorage point.…”

Section: The Rigid External Device (Red) For Midface Distraction Thatmentioning

confidence: 99%

“…The halo is produced commercially and there are two companies that manufacture it at this time. The system that we originally designed for cleft patients 6 was also used for craniofacial patients. Based on the experience of the baby, we pulled from four points (two supra orbital and two at the dental level through the intraoral splint traction hooks).…”

Section: You Have Been Working With Red For Over 20 Years Along Thesmentioning

confidence: 99%

An interview with Alvaro Alfredo Figueroa

2015

Dental Press J. Orthod.

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Treatment of midfacial hypoplasia in syndromic and cleft lip and palate patients by means of a rigid external distractor (RED)

Cited by 7 publications

References 33 publications

Maxillary Distraction Osteogenesis

Maxillary Distraction Osteogenesis

Comprehensive management of Crouzon syndrome: A case report with three-year follow-up

An interview with Alvaro Alfredo Figueroa

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