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Treatment of maxillary cleft palate: Distraction osteogenesis vs. orthognathic surgery
PURPOSE: The purpose of this paper is to compare the treatment of hypoplastic, retruded maxillary cleft palate using distraction osteogenesis vs. orthognathic surgery in terms of stability and relapse, growth after distraction and soft tissue profile changes. MATERIALS AND METHODS: The cleft patient...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2012
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3591052/ https://www.ncbi.nlm.nih.gov/pubmed/23483803 http://dx.doi.org/10.4103/2231-0746.101336 |
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author | Rachmiel, Adi Even-Almos, Michal Aizenbud, Dror |
author_facet | Rachmiel, Adi Even-Almos, Michal Aizenbud, Dror |
author_sort | Rachmiel, Adi |
collection | PubMed |
description | PURPOSE: The purpose of this paper is to compare the treatment of hypoplastic, retruded maxillary cleft palate using distraction osteogenesis vs. orthognathic surgery in terms of stability and relapse, growth after distraction and soft tissue profile changes. MATERIALS AND METHODS: The cleft patients showed anteroposterior maxillary hypoplasia with class III malocclusion and negative overjet resulting in a concave profile according to preoperative cephalometric measurements, dental relationship, and soft tissue analysis. The patients were divided in two groups of treatment : S0 eventeen were treated by orthognathic Le Fort I osteotomy fixed with four mini plates and 2 mm screws, and 19 were treated by maxillary distraction osteogenesis with rigid extraoral devices (RED) connected after a Le Fort I osteotomy. The rate of distraction was 1 mm per day to achieve Class I occlusion with slight overcorrection and to create facial profile convexity. Following a 10 week latency period the distraction devices were removed. RESULTS: In the RED group the maxilla was advanced an average of 15.80 mm. The occlusion changed from class III to class I. The profile of the face changed from concave to convex. At a 1-year follow up the results were stable. The mean orthognathic movement was 8.4 mm. CONCLUSION: In mild maxillary deficiency a one stage orthognathic surgery is preferable. However, in patients requiring moderate to large advancements with significant structural deficiencies of the maxilla or in growing patients the distraction technique is preferred. |
format | Online Article Text |
id | pubmed-3591052 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2012 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-35910522013-03-11 Treatment of maxillary cleft palate: Distraction osteogenesis vs. orthognathic surgery Rachmiel, Adi Even-Almos, Michal Aizenbud, Dror Ann Maxillofac Surg Original Article - Comparative Study PURPOSE: The purpose of this paper is to compare the treatment of hypoplastic, retruded maxillary cleft palate using distraction osteogenesis vs. orthognathic surgery in terms of stability and relapse, growth after distraction and soft tissue profile changes. MATERIALS AND METHODS: The cleft patients showed anteroposterior maxillary hypoplasia with class III malocclusion and negative overjet resulting in a concave profile according to preoperative cephalometric measurements, dental relationship, and soft tissue analysis. The patients were divided in two groups of treatment : S0 eventeen were treated by orthognathic Le Fort I osteotomy fixed with four mini plates and 2 mm screws, and 19 were treated by maxillary distraction osteogenesis with rigid extraoral devices (RED) connected after a Le Fort I osteotomy. The rate of distraction was 1 mm per day to achieve Class I occlusion with slight overcorrection and to create facial profile convexity. Following a 10 week latency period the distraction devices were removed. RESULTS: In the RED group the maxilla was advanced an average of 15.80 mm. The occlusion changed from class III to class I. The profile of the face changed from concave to convex. At a 1-year follow up the results were stable. The mean orthognathic movement was 8.4 mm. CONCLUSION: In mild maxillary deficiency a one stage orthognathic surgery is preferable. However, in patients requiring moderate to large advancements with significant structural deficiencies of the maxilla or in growing patients the distraction technique is preferred. Medknow Publications & Media Pvt Ltd 2012 /pmc/articles/PMC3591052/ /pubmed/23483803 http://dx.doi.org/10.4103/2231-0746.101336 Text en Copyright: © Annals of Maxillofacial Surgery http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article - Comparative Study Rachmiel, Adi Even-Almos, Michal Aizenbud, Dror Treatment of maxillary cleft palate: Distraction osteogenesis vs. orthognathic surgery |
title | Treatment of maxillary cleft palate: Distraction osteogenesis vs. orthognathic surgery |
title_full | Treatment of maxillary cleft palate: Distraction osteogenesis vs. orthognathic surgery |
title_fullStr | Treatment of maxillary cleft palate: Distraction osteogenesis vs. orthognathic surgery |
title_full_unstemmed | Treatment of maxillary cleft palate: Distraction osteogenesis vs. orthognathic surgery |
title_short | Treatment of maxillary cleft palate: Distraction osteogenesis vs. orthognathic surgery |
title_sort | treatment of maxillary cleft palate: distraction osteogenesis vs. orthognathic surgery |
topic | Original Article - Comparative Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3591052/ https://www.ncbi.nlm.nih.gov/pubmed/23483803 http://dx.doi.org/10.4103/2231-0746.101336 |
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