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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.
Summary
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.
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.
