Accuracy of Virtually Planned Maxillary Distraction in Cleft Patients - An Evaluative Study

Area of Science:

• Craniofacial surgery
• Orthognathic surgery
• Cleft lip and palate treatment

Background:

• Maxillary hypoplasia in cleft lip and palate (CLP) patients often requires maxillary distraction.
• Three-dimensional (3D) planning enhances distraction accuracy, reduces operative time, and minimizes complications.

Purpose of the Study:

• To evaluate the accuracy of internal maxillary distraction guided by 3D virtual planning in CLP patients.
• To provide evidence supporting the efficacy of virtual osteotomy and distraction procedures.

Main Methods:

• Eleven CLP patients with severe maxillary hypoplasia underwent internal maxillary distraction.
• Virtual planning was utilized for osteotomies, distractor positioning, and distraction vector design.
• Surgical guides facilitated the transfer of virtual plans to the operative procedure, with accuracy assessed via postoperative CT scans.

Main Results:

• High accuracy was observed, with 90% of maxillary surface points showing dislocation <1.5 mm.
• The majority of zygomatic screws were placed within 0.8-1 mm of their planned positions.

Conclusions:

• Virtual planning leads to highly accurate distractor placement.
• A customized distraction vector is crucial for achieving the desired final maxillary position.