Occlusal and Functional Improvement of Patients With Midfacial Hypoplasia Corrected Using Intraoral Tooth-Borne Mid-Maxillary Osteodistractors at Teaching Hospital-Karapitiya, Sri Lanka

Abstract

Objective: Mid-maxillary osteodistraction (MMOD) is a novel technique. This study seeks to assess the occlusal and functional improvement of patients with midfacial hypoplasia secondary to cleft lip and palate. Design: This was done as a retrospective study at the Regional Cleft Centre of the Teaching Hospital-Karapitiya (THK). Participants: A total of 81 patient records were accessed on those who underwent MMOD with a tooth-borne intraoral device from January 1, 2007, to December 31, 2016, at THK. Methods: Records of the patients included pre- and post-treatment lateral cephalograms, study models, speech assessments, and photographs. Results: An advancement ranging from 5 to 12 mm (mean, 8.14 mm) was achieved in all patients; 80% (n = 63) and 87.65% (n = 71) showed improvement in consonant production and quality of speech. These were statistically significant (P < .05). With regard to the Peer Assessment Rating score assessing the occlusal improvement, 97.6% showed an improvement whereas only 2 patients showed no improvement. There was a significant improvement in sella (S), nasion (N), and point A (SNA) angle; point A, the nasion, and point B (ANB) angle; and the maxillary length over the treatment period (P < .05). The change in the ANB angle and maxillary length significantly differed between genders with males having a comparatively higher improvement. The profile improvements were noteworthy on the profile photographs. Conclusion: This relatively novel approach to maxillary advancement by maxillary distraction using a combined surgical and modified orthodontic technique has proven to be successful. This protocol and the technique have improved function, occlusion, and the aesthetics.

A bibliometric analysis of research on craniomaxillofacial distraction osteogenesis from 2000 to 2021

“…Further research is needed, however, on the mechanistic immune status of craniofacial sutures and the interactions between immune cells and other cell types ( 48 ). In terms of improved technology, 3D virtual surgical planning (VSP) and CAD/CAM technology can effectively reduce the total treatment time and allow patients to obtain a class I occlusion at the conclusion of the distraction ( 48 ) and the The use of a tooth-borne intraoral device in conjunction with the Mid-Maxillary Osteodistraction (MMOD) technique has been shown to be effective ( 49 ). However, the long-term stability of these improved techniques remains to be investigated.…”