Main Instructor Wu Te-Ju
Department / Institution Orthodontic department, Kaohsiung Chang Gung Memorial Hospital
Classification Case report
Maxillary distraction osteogenesis (DO) has been developed as an innovative surgical option for correcting cleft-related maxillary retrusion at early stage of life. The maxillary DO procedure involves complete high LeFort I osteotomy for creating mobile maxillary segment and, subsequently, the distraction devices were equipped for progressively achieving great amount of maxillary advancement. The rigid external distraction (RED) system has become a widely used approach for DO, with acceptable skeletal relapse and excellent esthetic outcome.
A 13-year-old unilateral cleft and palate male patient possessed severe maxillary retrusion, and unaesthetic retrusive midface with -4.0 mm reverse overjet. The patient was treated with LeFort I osteotomy including pterygomaxilliary dysjunciton and down-fracture procedure. RED system was utilized for maxillary advancement after a 5-day latent period. Distraction was started at a rate of 1 mm per day, and the reverse overjet was over-corrected to 6.0 mm after 25-day distraction period. Facemask was used for the maintenance of DO result. The completion of orthodontic treatment was 26 months after DO, with proper overjet and overbite, and the result was stable after 1 year of retention.
「Discussion and Summary」
The anteroposterior of maxilla exhibited minimal relapse of 0.5 mm at point A after 1-year retention. However, the RED system allowed us to obtain a significant total maxillary advancement of 6.0 mm and, consequently, to eliminate the additional orthognathic surgery procedure.
Successful Treating Cleft-related Maxillary Retrusion with Distraction Osteogenesis Using Rigid External Distraction (RED) Device