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Related Experiment Video

Updated: May 16, 2026

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Vector control in internal midface distraction using temporary anchorage devices.

Cameron Francis1, Elizabeth Rommer, Salim Mancho

  • 1Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles, 4650 Sunset Boulevard, Los Angeles, CA 90027, USA.

The Journal of Craniofacial Surgery
|November 17, 2012
PubMed
Summary

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Orthodontic microimplants and class III elastics counteract midface clockwise rotation during distraction osteogenesis. This technique improves orbital appearance and corrects malocclusion in children with midface hypoplasia.

Area of Science:

  • Craniofacial surgery
  • Orthodontics
  • Pediatric plastic surgery

Background:

  • Le Fort III and monobloc distraction osteogenesis are primary treatments for severe midface hypoplasia.
  • Internal distraction devices offer advantages but can cause clockwise midface rotation, leading to hollow orbits.

Purpose of the Study:

  • To present a novel technique using orthodontic microimplants and class III elastics to counteract clockwise rotation during midface distraction.
  • To evaluate the efficacy of this technique in improving orbital appearance and correcting malocclusion.

Main Methods:

  • A Le Fort III distraction on a cadaver model measured orbital height with and without class III elastics.
  • A case series of 17 patients with midface or frontofacial hypoplasia treated with distraction and microimplant-anchored elastics was reviewed.

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Main Results:

  • Cadaveric measurements showed class III elastics counteracted clockwise rotation and maintained orbital height.
  • The patient series demonstrated correction of malocclusion and improved midface projection without significant vertical orbital changes.

Conclusions:

  • Microimplant-anchored class III elastics are effective in preventing clockwise rotation during midface distraction.
  • This technique improves aesthetic outcomes and functional occlusion in pediatric patients with midface hypoplasia.