Maxillary Advancement by Distraction Osteogenesis in Maxillary Hypoplasia

Abstract

Cleft lip and palate patients (CLP) are borne with a challenging deformity that requires multiple surgical interventions in order to reach functional and esthetic harmony. Distraction osteogenesis has become a widely used treatment of maxillary hypoplasia in CLP-patients because of the reports of better stability and the possibility for larger advancements. We report our treatment experience with a 19 year old cleft lip and palate female patient, presented with maxillary hypoplasia associated with a class III malocclusion. The treatment plan was orthodontic treatment combined with maxillary distraction osteogenesis to correct skeletal discrepancy and improve facial appearance. Pre-operatively a tooth borne distraction device was fabricated (Hyrex screw). The appliance was luted in the patient’s mouth 1 day prior to surgery. Intra-operatively anterior maxillary osteotomy was done. Distraction osteogenesis for maxillary hypoplasia resulted in a stable advancement of 10 mm. Hyrex screw was activated 1 mm per day after a latency period of seven days. No relapse was found both clinically and cephalometrically on review. Maxillary advancement by distraction osteogenesis is now frequently used to correct severe maxillary hypoplasia in cleft patients. The intraoral distraction devices are simple and easy to use. Cleft lip and palate patients experience a high level of satisfaction with functional parameters and aesthetics after surgical-orthodontic treatment of maxillary hypoplasia.

Keywords: Cleft lip and palate, maxillary hypoplasia, distraction osteogenesis, oral and maxillofacial surgery

Cite this Article:

Tanvi Vijay, Abhishek Kumar Singh, Shivendra Kumar Singh et al.. Maxillary Advancement by Distraction Osteogenesis in Maxillary Hypoplasia. Research and Reviews: Journal of Dentistry (RRJoD). 2015; 6(1): 18–22p.