The distraction osteogenesis in midfacial hypoplasia

Area of Science:

• Craniofacial surgery
• Orthodontics
• Regenerative medicine

Background:

• Severe midfacial retrusion in cleft patients causes masticatory and psychological issues.
• Distraction osteogenesis (DO) is a technique for generating new bone via tensile stress.
• Rigid external distraction (RED) devices offer a method for controlled bone movement.

Purpose of the Study:

• To present the clinical outcomes of treating a cleft patient with severe maxillary deficiency using a RED device.
• To improve facial profile, maxillary incisal display, overjet/overbite, and dental alignment.
• To evaluate the stability and impact on velopharyngeal competence.

Main Methods:

• A Le Fort I osteotomy was performed on a cleft patient with severe maxillary deficiency.
• A rigid external distraction (RED) device was applied, with traction directed to the maxilla via an intraoral splint.
• The RED device's halo was secured to the cranium with scalp screws.

Main Results:

• A well-balanced facial profile and good dental alignment were achieved.
• The patient experienced significant improvement in self-esteem.
• Maxillary advancements via distraction showed stability with minimal velopharyngeal impact.

Conclusions:

• Distraction osteogenesis with a RED device is effective for correcting severe maxillary deficiency in cleft patients.
• This treatment approach leads to improved aesthetics, function, and psychological well-being.
• Maxillary advancement using distraction osteogenesis offers a stable alternative to traditional orthognathic surgery.