Initial Experience With a New Intraoral Midface Distraction Device

Abstract

Maxillary hypoplasia that necessitates surgical advancement affects approximately 25% of patients born with cleft lip and palate. Syndromic conditions such as Crouzon may also be accompanied by significant maxillary hypoplasia. Severe maxillary hypoplasia can result in airway obstruction, malocclusion, proptosis, and facial disfigurement. For optimal stability, severe hypoplasia is best addressed with maxillary distraction osteogenesis. Twenty-two patients (15 boys, 7 girls, ages 6–16 years, mean age 10 years) with severe midface hypoplasia underwent midface distraction with new internal maxillary distraction (IMD) device at our institution. Total distraction distances ranged from 15 to 30 mm. There were no major complications, and all of them had improvement in functional and aesthetic parameters. There were 2 minor complications and 2 patients failed to distract the full distance because of converging vectors. Early maxillary distraction in patients with severe midface hypoplasia is a useful technique to provide interval correction of severe maxillary hypoplasia before skeletal maturity and definitive orthognathic surgery is contemplated, and it is a good tool to improve occlusion, aesthetics, and self-perception in younger patients.

A Technical Innovation in Midface Advancement With the External Frame Distraction Device

“…The external frame device is also known to be more effective in severe cases of retrusion needing greater anterior movement of the maxilla. Finally, there is an added advantage of removing the frame without requiring a second surgery (Nout et al, 2006; Burstein et al, 2015).…”

A novel skeletal anchorage for rigid external distractor

“…[6,17] This study aimed to overcome some of these limitations by modifying the method by which facial bones are anchored to an extraoral distraction device, specifically RED II. Several authors [1,5,10,11] describe one of the limitations being the need for teeth to be used as anchorage.…”

“…In 1997, some authors proposed the use of the rigid external distraction device I (RED I) [4][5][6] in order to overcome these shortcomings. The device was anchored to the skull and the denture in order to distract facial bones.…”

Distracción osteogénica del tercio medio facial. Reporte de dos casos clínicos

“…Habitualmente este tipo de tratamientos es utilizado en malformaciones faciales severas, donde las técnicas convencionales, como la cirugía ortognática, por ejemplo, son limitadas en sus resultados 2 .…”