[Distraction osteogenesis in the midface. Indications, technique and first long-term results]

Since the beginning of 1998, eleven patients have been treated by osteodistraction to correct hypoplasia of the maxilla and midface of various origins. Among them were six patients who were treated by high LeFort I osteotomies and insertion of subcutaneous intraoral distraction devices in the malar region. In the remaining five patients extraoral distraction devices were applied after LeFort I, II and III osteotomies. Distraction osteogenesis was successful in all cases, resulting in a mean sagittal bone gain measured parallel to the skull base of 9.5 mm (range 4.5-12.0) in the group treated with intraoral distractors and a mean of 19.4 mm in the extraoral distraction group (range 15.0-25.0). All patients were kept under orthodontic supervision before, during, and after osteodistraction. In eight patients long-term cephalometric and clinical evaluation after a mean follow-up period of 24 months in the intraoral distraction group (range 22-26) and 12 months in the extraoral distraction group (range 10-14) show stable results concerning the skeletal and dental relations. Long-term follow-up is necessary.