Palatal Distraction in a Canine Cleft Palate Model

Abstract

The purpose of this study was to determine whether the canine hard palate can be lengthened by distraction osteogenesis in a cleft palate model using a mostly submucosal distractor. Five mongrel dogs were used. After raising mucoperiosteal flaps, a midline strip of bone was removed from the hard palate of each dog to simulate the bony defect seen in a cleft palate. A transverse osteotomy was then made to separate the posterior segment of the hard palate from the anterior segment. Posterior osteotomies were also made laterally parallel to the teeth so that the 2 posterior segments (one on either side of the bony cleft) were mobile. An intraoral distractor that was mostly submucosal was attached to the anterior hard palate and both segments of the mobilized posterior hard palate. Radiopaque bone markers were placed, and x-rays were obtained. After a 10-day latency period, the distractor was expanded 0.675 mm per day until it had been lengthened 10.125 mm. Distractors were left in place for an additional 8 weeks. After distractor removal, animals were observed for an additional 8 weeks before euthanization. Follow-up x-rays and histologic examinations were performed. New bone formation was found at the site of distraction in all dogs at the time of death. This new bone was seen on the follow-up x-rays and on histologic examination of the hard palates using both hematoxylin and eosin staining and Masson's trichrome stain. Distraction osteogenesis using a mostly submucosal device is an effective technique for lengthening the hard palate in a canine cleft palate model. The technique may eventually provide an alternative treatment for velopharyngeal incompetence in humans that is more precise and involves less morbidity than existing treatments.

A new approach to repairing cleft palate and acquired palatal defects with distraction osteogenesis

“…The cats used in this study were all juveniles aged 0.5-0.8 years old; the longest time interval followed after active distraction was 12 weeks, after which the cats would have reached maturity. It could therefore be observed that there was no influence of the DO technique on development of the oral and maxillofacial area 3,4 . In addition, comparative measurement of the jaws using experimental casts implied that the DO procedure might not retard the normal developmental tendency of the midface, and could maintain a normal occlusal relation in these cats.…”

Distraction Osteogenesis for Cleft Palate Closure in a Canine Model

“…Ascherman et al 18 also studied hard palate lengthening with DO in a canine model. They used a 10-day la-tency period, and distracted at a rate of 0.675 mm/d for 15 consecutive days, with 8 weeks of consolidation.…”

“…All 5 dogs they studied had new bone formation at the site of distraction. Ascherman et al 18 concluded that it is possible to lengthen the canine hard palate with DO.…”

Comparing Surgical Advancement Outcomes of Retruded Maxilla in a Group of Egyptian Cleft Lip and Palate Subjects

“…Problems associated with maxillary retrusion are functional and esthetic as facial disfigurement, occlusal problems, temporomandibular joint pain, and psychological problems [8], [9]. The maxilla should be advanced to a position that catches up to the mandibular growth.…”