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Does the Rigid External Distraction Device Allow for Long-Term Control of Maxillary Pitch in Cleft Maxillary Distraction?

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Does the Rigid External Distraction Device Alter Maxillary Pitch in Cleft Maxillary Distraction?

Alexander T Mathews1, Chad W Dammling1, Peter D Waite1

  • 1University of Alabama at Birmingham School of Dentistry, Birmingham, AL, USA.

The Cleft Palate-Craniofacial Journal : Official Publication of the American Cleft Palate-Craniofacial Association
|June 23, 2022
PubMed
Summary
This summary is machine-generated.

The rigid external distraction (RED) device can reposition the maxilla, but it caused a counterclockwise rotation of the palatal plane in cleft lip and palate patients. Further vector control methods may be needed for desired clockwise rotation.

Keywords:
cleft lip and palatedistraction osteogenesisorthognathic surgeryosteotomy

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Area of Science:

  • Craniofacial surgery
  • Orthodontics
  • Maxillofacial reconstruction

Background:

  • The rigid external distraction (RED) device is known for its ability to achieve three-dimensional repositioning of the maxilla.
  • Understanding its precise effects on maxillary rotation, specifically pitch, is crucial for optimizing treatment outcomes.

Purpose of the Study:

  • To assess the capability of the RED device to intentionally alter the maxillary pitch.
  • To evaluate the rotational changes in the palatal plane following maxillary distraction.

Main Methods:

  • A retrospective cohort study analyzing 50 patients over 12 years.
  • Cephalometric analysis of standardized lateral cephalograms comparing pre-distraction and post-consolidation variables.
  • Statistical comparison using a two-tailed paired t-test.

Main Results:

  • Mean maxillary advancement of 8.4 mm via distraction osteogenesis (DO).
  • Significant changes in SNA (10.2°), SNB (0.9°), and ANB (9.3°).
  • A mean counterclockwise rotation of the palatal plane by -4.4° was observed, despite superior eyelet placement.

Conclusions:

  • The RED device induced a counterclockwise rotation of the palatal plane in this cleft lip and palate population.
  • Adjunctive methods for vector control should be considered to achieve intentional clockwise rotation with the RED device.