World Journal of Dentistry

Register      Login

VOLUME 2 , ISSUE 2 ( April-June, 2011 ) > List of Articles

RESEARCH ARTICLE

Evaluation of Reduction in Relapse and Enhancement of Patient Compliance with Hybrid Technique of Maxillary Distraction Osteogenesis: A Long-term Study

S Deepak, Girish S Rao

Citation Information : Deepak S, Rao GS. Evaluation of Reduction in Relapse and Enhancement of Patient Compliance with Hybrid Technique of Maxillary Distraction Osteogenesis: A Long-term Study. World J Dent 2011; 2 (2):99-104.

DOI: 10.5005/jp-journals-10015-1064

Published Online: 01-06-2011

Copyright Statement:  Copyright © 2011; The Author(s).


Abstract

Introduction and objectives

Hybrid technique of maxillary distraction osteogenesis is the latest advance introduced to correct maxillary hypoplasia in cleft lip and palate patients. The objectives of this study was to clinically and cephalometrically evaluate the stability of advanced maxilla over a period of 3 years, after maxillary advancement with hybrid technique of distraction osteogenesis in cleft lip and palate patients, and to asses the patient compliance during the procedure.

Materials and methods

Ten cleft lip and palate patients having severe maxillary hypoplasia underwent surgical correction of maxillary hypoplasia using hybrid technique of distraction osteogenesis where the rigid external distraction device was immediately removed after the active distraction period, and the advanced maxilla was fixed with rigid internal fixation. Clinical and cephalometrical analyses of the craniofacial skeleton were done at the predistraction, after active distraction and 3 years postdistraction period.

Results

The results of the clinical and cephalometrical evaluation indicated that there was an effective horizontal advancement of maxilla, increase in the length of the maxilla and a positive correction of overjet all together esthetically improving the facial profile. Three years post distraction evaluation of both the hard and soft tissue profiles indicated a very minimal relapse. All the patients had greater level of compliance after the removal of rigid external distractor and fixation of the distracted maxilla.

Conclusion

This study concluded that hybrid technique of maxillary distraction osteogenesis in cleft lip and palate patients gave esthetically acceptable facial profile with minimal relapse after 3 years of follow-up and an increased level of patient compliance during the procedure.


PDF Share
  1. Distraction osteogenesis: Origins and evolution. In: McNamaru Jr JA, Trotman CA (Eds). Distraction of osteogenesis and tissue engineering. ANN Arbor, Michingan: Centering for human growth and development, the University of Michigan 1998;34: 1-35.
  2. Management of severe maxillary deficiency in childhood and adolescence through distraction osteogenesis with an external, adjustable, rigid distraction device. J Craniofac Surg 1997;8:181-85.
  3. Rigid external distraction, its application in cleft maxillary deformities. Plast Reconstruct Surg 1998;102:1360-72.
  4. Long-term after maxillary advancement in patients with clefts. Cleft Palate Craniofac J Mar 1993;30(2):237-43.
  5. Historical development and evolution of craniofacial distraction osteogenesis. Mikhail L Samchukov, Jason B Cope, Alexander M Cherkashin (Eds). Craniofacial distraction osteogenesis 2001;3-17.
  6. On the means of lengthening in the lower limbs, the muscles and tissues which are shortened through deformity. J Orthop Surg 1905;2:353-69.
  7. The operative lengthening of the femur JAMA 1921;77:934.
  8. A retrospective study of the stability of midface osteotomies in cleft lip and palate patients. Br J Oral Maxillofac Surg 1989;27(4):265-76.
  9. Bone lengthening in the craniofacial skeleton. Ann Plast Surg 1990;24(3):231-23.
  10. Membranous bones lengthening: A serial histological study. Ann Plastic Surg 1992;29:2-7.
  11. Use of distraction osteogenesis for maxillary advancement: Preliminary results. J Oral maxillofac Surg 1994;52:28-286.
  12. Multiple segmental gradual distraction of facial skeleton: An experimental study. Ann Plast Surg 1996;36:52-59.
  13. Maxillary midface distraction in children with cleft lip and palate: A preliminary report. Plast Reconstr Surg 1997;99:1421-28.
  14. Maxillary distraction: Aesthetic and functional benefits in cleft lip palate and prognatic patients during mixed dentition. Plast reconstr Surg 1998;101:951-63.
  15. Callus distraction of the midface in the severely atrophied maxilla—case report. Cleft palate Craniofac J 1999;36:457-61.
  16. Maxillary distraction osteogenesis. Two-dimensional mathematical model. J Craniofac Surg 2000;11:312-17.
  17. Soft tissue profile changes after maxillary advancement with distraction osteogenesis by use of a rigid external distraction device: A 1-year follow-up. J Oral Maxillofac Surg 2000;58: 959-69.
  18. Maxillary distraction osteogenesis for cleft lip and palate children using an external, adjustable, rigid distraction device: A report for two cases. J Oral Maxillofac Surg 2001;59:1492-96.
  19. Radiographic evaluation of bone formation in the pterygoid region after maxillary distraction with a rigid external distraction (RED) device. J Oral Maxillofac Surg Sep 2000;58(9):959-69; discussion 969-70.
  20. Le Fort I soft tissue distraction: A hybrid technique. Journal of Cranio facial Surgery 2002;13(4):572-76.
  21. Rigid external distraction osteogenesis for a patient with maxillary hypoplasia and oligodontia. Cleft Palate Craniofac J Mar 2003;40(2):207-13.
  22. Anesthetic concerns of external maxillary distraction osteogenesis. J Craniofac Surg 2004;15:78-81.
  23. Distraction osteogensis for the cleft lip and palate patient. Clin Plas Surg Apr 2004;31(2):291-302.
  24. Long-term results of distraction osteogenesis of the maxilla and midface. Br J Oral Maxillofac Surg 2002;40:473-79.
  25. Longitudinal cephalometric analysis after maxillary distraction osteogenesis. J Craniofac Surg Jul 2005;16(4):683-88.
  26. Long-term skeletal and dental changes in patients with cleft lip and palate after maxillary distraction: A report of three cases treated with a rigid external distraction device. Cranio Apr 2005;23(2):152-57.
  27. A meta-analysis of cleft maxillary osteotomy and distraction osteogenesis. Int J Oral Maxillofac Surg 2006;35:14-24.
  28. Maxillary distraction osteogenesis with rigid external distraction. Atlas oral Maxillofac Surg Clin North AM 1999;7:15-28.
  29. The tension-stress effect on the genesis and growth of tissues (Part 1): The influence of the stability of fixation and soft tissue preservation. Clini Orthop 1989;238-49.
  30. Removable splint with locking attachments for maxillary distraction osteogenesis with the RED system. International Journal of Oral and Maxillofacial Surgery 2007;36(12):1153-57.
  31. Patient satisfaction related to rigid external distraction osteogenesis. International Journal of Oral and Maxillofacial Surgery 2007;36(10):896-99.
  32. Maxillary distraction osteogenesis in cleft lip and palate patients with skeletal anchorage. The Cleft Palate Craniofacial Journal 2007;44(2): 137-41.
  33. Long-term skeletal stability after maxillary advancement with distraction osteogenesis in nongrowing patients. Journal of Oral and Maxillofacial Surgery 2008;66(9):1833-46.
  34. External frame distraction osteogenesis of the midface in the cleft patient. Indian Journal of Plastic Surgery 2009;42(3):168-73.
  35. Multiplanar and combined distraction osteogenesis for three-dimensional and functional reconstruction of unilateral large maxillary defects. British Journal of Oral and Maxillofacial Surgery. British Journal of Oral and Maxillofacial Surgery 2009;47(2):106-10.
  36. Comparison of the efficiency of two types of intraoral splints in the RED system for maxillary distraction osteogenesis. Orthodontic Waves 2010;69(3):102-09.
  37. Five-year follow-up of maxillary distraction osteogenesis on the dentofacial structures of children with cleft lip and palate. Journal of Oral and Maxillofacial Surgery 2010;68(4):744-50.
  38. Midface distraction osteogenesis: Internal vs external devices. International Journal of Oral and Maxillofacial Surgery 2011;40(2):139-45.
  39. Comparison of perioperative morbidity after Le Fort III and monobloc distraction osteogenesis. British Journal of Oral and Maxillofacial Surgery 2011;49(2):131-34.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.