Long-Term Skeletal Stability After Maxillary Advancement With Distraction Osteogenesis in Nongrowing Patients

Kanno, Takahiro; Mitsugi, Masaharu; Hosoe, Michi; Sukegawa, Shintaro; Yamauchi, Kensuke; Furuki, Yoshihiko

doi:10.1016/j.joms.2007.10.013

Cited by 56 publications

(54 citation statements)

References 39 publications

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“…Some reports note that in large advancements are those exceeding 10 mm [17]. Others define large maxillary advancements as those beyond 8 mm [18]. while others have reduced the limit of maxillary advancement to 5 mm with consideration of the palatal scar tissue formation [19].…”

Section: Discussionmentioning

confidence: 99%

“…It allows large advancement of the underlying skeletal foundation with bony regeneration and elongation of the investing soft tissue. This gives better stability especially in cleft patients who require large advancements and present with severe palatal scaring [18]. Cheung compared relapse in clefts undergoing Le Fort I advancement of 5.3 mm with distraction group of >6.7.…”

Section: Discussionmentioning

confidence: 99%

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Stability of maxillary advancement using external rigid distractors in cleft lip and palate patients

Abuzinada¹,

Alyamani²

2012

OJST

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Purpose: To evaluate the skeletal changes associated with maxillary advancement using the external rigid distractor in cleft lip and palate patients after distraction and to assess the stability of these changes. Patients and Methods: Eight cleft lip and palate patients with maxillary hypoplasia underwent maxillary distraction osteogenesis using external rigid devise. Lateral cephalometric records were obtained before distraction T1 and after completing active distraction T2. After a three month follow up period a final lateral cephalometric record was evaluated T3. Results: The maxilla was significantly advanced as indicated by the increase in maxillary depth angle and effective maxillary length (median difference, 10 mm). The palatal plane angle showed a significant increase (median difference, 5˚), showing clockwise rotation. At T3 there was a slight decrease in maxillary depth angle (median difference, 3˚). Effective maxillary length decreased significantly at T3 (median difference, 2 mm). The palatal plane angle decreased (median difference, 3˚) and almost returned to its original position, showing a counterclockwise rotation. Conclusion: Maxillary advancement using external rigid distractor resulted in clockwise rotation of maxilla with increase in palatal plane angle and slight increase in mandibular plane angle. The amount of maxillary advancement was slightly reduced during follow up and the palatal plane almost returned to its original position. These changes showed good stable clinical results.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Stability of maxillary advancement using external rigid distractors in cleft lip and palate patients

Abuzinada¹,

Alyamani²

2012

OJST

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Section: Introductionmentioning

confidence: 99%

“…When a hypoplastic cleft palate is treated by conventional Le Fort I osteotomy and major advancement, extreme discrepancies make stabilization difficult, and the added effect of palatal scarring can result in significant postoperative relapse 1,5) . Distraction osteogenesis (DO) with histogenesis is an alternative method for maxillary advancement in patients with a tendency to relapse, including those with cleft palate 5,6) . Although maxillary osteotomy surgery with placement of a DO device would seem to be a relatively simple, safe, and viable treatment alternative for patients with CLP-related midfacial hypoplasia, the hardware systems available for DO require comprehensive system modifications in terms of size, stiffness, adjustability, and customizability, and still need an intraoral maxillary distractor [2][3][4] .…”

Section: Introductionmentioning

confidence: 99%

“…Although maxillary osteotomy surgery with placement of a DO device would seem to be a relatively simple, safe, and viable treatment alternative for patients with CLP-related midfacial hypoplasia, the hardware systems available for DO require comprehensive system modifications in terms of size, stiffness, adjustability, and customizability, and still need an intraoral maxillary distractor [2][3][4] . Based on our accumulated clinical results and a long-term follow-up study 5) , we have started to apply DO in the midface, primarily by using rigid extraoral midfacial distraction device systems in patients with CLP deemed on preoperative evaluation to require a large degree of advancement (> 8 mm). Given the considerable improvements in surgical techniques and distractor modifications in recent decades 2,4,7) , large maxillary advancement, which is often needed in patients with CLP, can now be achieved those with CLP, the skeletal relapse rate remains one of the most important issues in terms of long-term stability [3][4][5] .…”

Section: Introductionmentioning

confidence: 99%

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Long-term Skeletal Stability of Computer-Assisted Maxillary Distraction Osteogenesis for Patients with Cleft Lip and Palate-Related Midfacial Hypoplasia

Kanno

Sukegawa

Shibata

et al. 2017

J. Hard Tissue Biology.

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Distraction osteogenesis (DO) has gained acceptance for treating cleft-related deformities involving severe maxillary hypoplasia. Modern computer-assisted surgery (CAS) has progressed rapidly and has been incorporated into oral-maxillofacial surgery. In this retrospective study, we evaluated the long-term skeletal stability of the maxilla repositioned using DO with CAS in patients with cleft-related midfacial hypoplasia. Three female patients (mean age, 21.0 years) requiring a mean maxillary advancement with DO of 11.0 (range, 10-12) mm were included. Based on preoperative computed tomography data, virtual reality surgical planning for maxillary DO with selection of the actual distractor components was done using three-dimensional rapid prototyping models. Surgery entailed a Le Fort I osteotomy and application of semi-custom-made intraoral distraction devices. DO was activated after a 5-day latency period at a rate of 1 mm/day until the appropriate amount of distraction was obtained. After a 4-week retention period, rigid internal fixation and distractor removal were performed (T1). Lateral cephalometric films taken before DO (T0), at T1, 6 months after T1 (T2), and 3 years after T1 (T3) were analyzed. Maxillary point A in the Frankfort horizontal reference plane was used to assess skeletal changes in the maxillary position (x, y) at each time point (T1-T3). In all 3 patients, maxillary DO was safe and CAS with preoperative virtual image-guided simulation was feasible in terms of dental and skeletal relationships and facial profile, with a mean change at maxillary point A of 10.7 mm (7.0 mm horizontally, 8.1 mm inferiorly). Point A showed a moderate amount of skeletal relapse by T2 (1.0 mm, 13.8%, horizontally; 1.3 mm, 16.5%, superiorly; P < 0.05), with a small amount of further relapse at T3 (P > 0.05). DO with CAS can achieve long-term skeletal stability and is a promising minimally invasive bone regenerative treatment for cleft-related midfacial hypoplasia.

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A Novel Approach in Developing Facial Esthetics in Cleft Lip and Palate Patients

Erverdi¹,

Motro²

2020

Alveolar Distraction Osteogenesis

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Long-Term Skeletal Stability After Maxillary Advancement With Distraction Osteogenesis in Nongrowing Patients

Cited by 56 publications

References 39 publications

Stability of maxillary advancement using external rigid distractors in cleft lip and palate patients

Stability of maxillary advancement using external rigid distractors in cleft lip and palate patients

Long-term Skeletal Stability of Computer-Assisted Maxillary Distraction Osteogenesis for Patients with Cleft Lip and Palate-Related Midfacial Hypoplasia

A Novel Approach in Developing Facial Esthetics in Cleft Lip and Palate Patients

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