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Experience with the transpalatal distractor in congenital deformities
Maarten J Koudstaal1, Karel G H van der Wal, Eppo B Wolvius
1Department of Oral and Maxillofacial Surgery, Erasmus University Medical Center Rotterdam, Dr Molewaterplein 40, 3015, Rotterdam, GD, The Netherlands. m.koudstaal@erasmusmc.nl
Mund-, Kiefer- Und Gesichtschirurgie : MKG
|September 6, 2006
Summary
The transpalatal distractor shows a high complication rate in patients with congenital craniofacial anomalies. This bone-borne device may not be ideal for maxillary widening in these complex cases.
Area of Science:
- Orthodontics
- Craniofacial Surgery
- Pediatric Dentistry
Background:
- Transpalatal distractors are bone-borne devices designed to minimize orthodontic side effects.
- Previous literature reports potential complications associated with their use.
Purpose of the Study:
- To evaluate the efficacy and complication rate of the transpalatal distractor in patients with congenital craniofacial anomalies.
- To identify challenges in using this device in specific patient populations.
Main Methods:
- Retrospective study of ten patients with congenital craniofacial anomalies, including clefts.
- Analysis of complications encountered during and after transpalatal distractor placement.
Main Results:
- Difficulties in initial placement due to thin palatal bone in narrow maxillae, leading to reduced primary stability.
- Challenges with abutment plate placement due to thick palatal mucosa, limiting space for the device module.
- Difficulties in module exchange and abutment plate refixation in patients with mental retardation.
- An overall complication rate of 60% was observed in the study group.
Conclusions:
- The transpalatal distractor may not be the optimal device for maxillary widening in patients with congenital deformities.
- Specific anatomical challenges and patient factors increase the risk of complications.
