Segmental Maxillary Distraction Osteogenesis With a Hybrid-Type Distractor in the Management of Wide Alveolar Cleft

Abstract

Objective:

To investigate segmental maxillary distraction osteogenesis (DO) with hybrid-type distractor in the management of wide alveolar cleft.

Patients and Methods:

Six patients underwent segmental DO with a hybrid-type distractor. After the success of DO and 3-month consolidation period, removal of the distractor was accompanied by alveolar bone graft with iliac bone. Panoramic radiograph and computed tomography scanning were taken preoperatively (T0) and the day after distractor removal (T1). The crest distance between the long axis of cleft nearby teeth was measured.

Result:

All patients completed the DO period, and the succeeding alveolar bone graft healing was uneventful. The mean cleft distance decrease was 12.05 mm (range: 10.1-13.5 mm). As for the mobility degree record of abutment tooth in the transport segment recorded, 6 patients were grading I° at T0, while 5 patients were grading I° and 1 patient was grading II° at T1.

Conclusion:

Segmental maxillary DO with the hybrid-type distractor is successful to reduce the cleft width in these cases, and it is promising in the treatment of wide dental alveolar cleft, especially for the adult patient.

Keywords

hybrid-type distractor segmental osteotomy wide alveolar cleft distraction osteogenesis

Get full access to this article

View all access options for this article.

References

Bousdras

Liyanage

Mars

Ayliffe

. Segmental maxillary distraction with a novel device for closure of a wide alveolar cleft. Ann Maxillofac Surg. 2014;4(1):60–63.

Dolanmaz

Karaman

Durmus

Malkoc

. Management of alveolar clefts using dento-osseous transport distraction osteogenesis. Angle Orthod. 2003;73(6):723–729.

Eppley

Sadove

. Management of alveolar cleft bone grafting—state of the art. Cleft Palate Craniofac J. 2000;37(3):229–233.

Erverdi

Yilmaz

Motro

Gozneli

Ugurlu

. Simultaneous alveolar cleft closure and dental midline correction with curvilinear intraoral distraction. Cleft Palate Craniofac J. 2014;51(3):344–349.

Kortebein

Nelson

Sadove

. Retrospective analysis of 135 secondary alveolar cleft grafts using iliac or calvarial bone. J Oral Maxillofac Surg. 1991;49(5):493–498.

Liou

Chen

Huang

Chen

. Interdental distraction osteogenesis and rapid orthodontic tooth movement: a novel approach to approximate a wide alveolar cleft or bony defect. Plast Reconstr Surg. 2000;105(4):1262–1272.

Mitsugi

Ito

Alcalde

. Maxillary bone transportation in alveolar cleft-transport distraction osteogenesis for treatment of alveolar cleft repair. Br J Plast Surg. 2005;58(5):619–625.

Picard

Diner

Galliani

Tomat

Vazquez

Carls

. Five years experience with a new intraoral maxillary distraction device (RID). Br J Oral Maxillofac Surg. 2011;49(7):546–551.

Rachmiel

Emodi

Gutmacher

Blumenfeld

Aizenbud

. Oral and dental restoration of wide alveolar cleft using distraction osteogenesis and temporary anchorage devices. J Craniomaxillofac Surg. 2013;41(8):728–734.

10.

Yen

SLK

Yamashita

Gross

Meara

Yamazaki

Kim

, Reinisch J. Combining orthodontic tooth movement with distraction osteogenesis to close cleft spaces and improve maxillary arch form in cleft lip and palate patients. American Journal of Orthodontics and Dentofacial Orthopedics. 2005;127(2): 224–232.