Maxillary advancement in cleft palate patients with intraoral distraction

Plaza, Adoración Martínez; Núñez, Mario Menéndez; Lara, Ildefonso Martinez; Solis, Jose Fernandez; Jiménez, Pablo Gálvez; Iglesias, Fernando Monsalve

doi:10.1016/j.maxile.2014.01.001

Cited by 1 publication

(2 citation statements)

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“…Principle advantages of RED resides in its ability to make larger advancements possible, to allow for vector adjustment during the entire period of active distraction and easy placement and removal 2 . However, the extra-oral placement and large size induce psychological stress with a potential risk of accidental injury to the head 24 . Internal distractor devices on the other hand decrease the physical and psychological stresses due to their placement intraorally and require shorter hospitalization.…”

Section: Discussionmentioning

confidence: 99%

“…2 However, the extra-oral placement and large size induce psychological stress with a potential risk of accidental injury to the head. 24 Internal distractor devices on the other hand decrease the physical and psychological stresses due to their placement intraorally and require shorter hospitalization. However, these devices have their inherent demerits which include inability to alter the vector orientation during the distraction phase, difficulty in placing the right and left distractors parallel to one another, discomfort related to stretch of the buccal tissues by distractor rods, limitation of distractor length, and the need for second operation to remove the devices.…”

Section: Discussionmentioning

confidence: 99%

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Cleft Maxillary Hypoplasia: Comparison of Techniques and Proposal of a Novel Treatment Protocol for Management

Richardson,

Sinai Khandeparker,

Krishna

et al. 2023

Journal of Craniofacial Surgery

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This study was designed to compare different techniques of managing cleft maxillary hypoplasia and to propose a treatment protocol taking patient’s age of presentation, amount of maxillary hypoplasia, and presence/absence of velopharyngeal insufficiency (VPI) into consideration. Five treatment modalities, viz. facemask therapy (Group I), anterior maxillary distraction (Group II), total maxillary distraction osteogenesis using rigid external distraction devices (Group III) and internal distraction devices (Group IV), and conventional orthognathic surgery (Group V), were assessed retrospectively using lateral cephalograms (taken at 3 intervals) and speech records (studied pre- and post-operatively). The results were subjected to statistical analysis. A P value of less than 0.05 was considered statistically significant. The mean advancement achieved in groups I, II, III, IV, and V was 4.2±1.54, 9.03±2.62, 11.82±1.18, 10.41±1.42, and 7.24±2.44 mm, respectively. The mean horizontal relapse noted in Groups I, II, III, IV, and V was 2.3 mm (n=8), 2.1 mm (n=14), 3.4 mm (n=10), 1.4 mm (n=5), and 2.4 mm (n=24), respectively. Compared to other groups, group II had fewer patients exhibiting relapse, a statistically significant observation. Similarly, statistically significant improvement in speech outcomes was found only in group II compared to other groups. Based on the results, a treatment protocol was proposed. The authors conclude that the proposed protocol would enable surgeons to decide the most appropriate treatment modality paying attention to not only the age of presentation and amount of advancement but also presence/absence of VPI which is instrumental in deciding upon the most appropriate treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%