Bone-Borne Palatal Distraction to Correct the Constricted Cleft Maxilla

Abstract

Rapid palatal expansion using a bone-borne distraction device in cleft patients with transverse maxillary hypoplasia who have failed nonsurgical orthodontic expansion provides adequate expansion necessary for alveolar bone grafting and stable results.

Stress and displacement pattern evaluation using two different palatal expanders in unilateral cleft lip and palate: a three-dimensional finite element analysis

“…Vyas et al reported that the use of microimplant-assisted palatal distraction as an adjunct to SARPE provided adequate stable skeletal expansion [28]. Even though clinically they could achieve the skeletal expansion, the complex loading pattern and the biomechanical effects of this bone-borne palatal expander on the maxillary bone and the circum-maxillary sutures have not been evaluated.…”

Transpalatal distraction osteogenesis prior to alveolar bone grafting in cleft lip and palate patients

“…SARME has recently been replaced by transpalatal distraction with superior results 5,9,11,19 . According to MOMMAERTS 12 conventional tooth-borne appliances produce greater loss of anchorage and more skeletal relapse during and after expansion.…”

“…Surgically assisted rapid maxillary expansion (SARME) has been proposed to produce better treatment results in adults and to prevent complications by surgically releasing the closed sutures resisting the expansion forces 1,17,19 . SARME has recently been replaced by transpalatal distraction with superior results 5,9,11,19 .…”

“…Transverse maxillary expansion with a bone-borne transpalatal distractor has been used with favourable results in congenital and acquired transverse maxillary deficiency 9,10,19 . Most of the published data on transpalatal distraction osteogenesis relate to series applied in non-congenital defects or case reports applied in congenital cases 10 .…”

Distraction Osteogenesis of the Maxillofacial Skeleton: Clinical and Radiological Evaluation

“…Recurrence of the collapse and alveolar bone effects are among the reported complications (Gunbay et al 2008a;Mommaerts, 1999;Suri & Taneja, 2008). Transverse maxillary expansion with a bone-borne transpalatal distractor has been used with favourable results in congenital and acquired transverse maxillary deficiency (Gunbay et al 2008a;Koudstaal et al, 2006;Mommaerts, 1999;Suri & Taneja, 2008;Vyas et al 2009). In many studies, effects of transversal expansion have been examined by posteroanterior cephalometric measurements in dentoalveolar, maxillary base and nasal regions.…”