A case of bilateral cleft lip and palate with maxillary retrognathia treated by a new internal device for maxillary distraction osteogenesis

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  • MORITA Kei-ichi
    Oral and Maxillofacial Surgery, Department of Oral Restitution, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
  • KIKUCHI Tsuyoshi
    Oral and Maxillofacial Surgery, Department of Oral Restitution, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
  • IMAIZUMI Fumiko
    Oral and Maxillofacial Surgery, Department of Oral Restitution, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
  • NEGISHI Ayako
    Oral and Maxillofacial Surgery, Department of Oral Restitution, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
  • TSUJI Michiko
    Maxillofacial Orthognathics, Department of Maxillofacial Reconstruction and Function, Division of Maxillofacial/Neck Reconstruction, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
  • OMURA Ken
    Oral and Maxillofacial Surgery, Department of Oral Restitution, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University

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Other Title
  • 新規創内固定型上顎骨延長装置を用いて治療した両側唇顎口蓋裂術後上顎後退症の1例
  • シンキ ソウナイ コテイガタ ジョウガクコツ エンチョウ ソウチ オ モチイテ チリョウ シタ リョウソク シンガク コウガイレツ ジュツゴ ジョウガク コウタイショウ ノ 1レイ

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Abstract

We clinically applied a new internal device for maxillary distraction osteogenesis, the Maxillary Distractor System (SYNTHES®). This internal distractor was used in a 17-year-old boy with bilateral cleft lip and palate who underwent maxillary distraction osteogenesis. Before distraction, he presented with a retrognathic maxilla with a minus 11 mm overjet. Following a bilateral alveolar bone graft with iliac bone 5 months before maxillary distraction, a Le Fort I osteotomy was performed, and an internal distractor was placed under general anesthesia. After a 4-day latency period, the maxilla was distracted at a rate of 1 mm/day by two activations per day. After completion of distraction, a cephalometric analysis showed a 15 mm maxillary advencement. After a 4-day consolidation period, the device was removed, and the distracted maxilla was fixed with plates under general anesthesia. The bone formation was evaluated by computed tomography, which showed partial bone formation at the anterior portion of the maxillary sinus 3 months after plate fixation surgery. The occlusion 8 months after plate fixation was satisfactory.<br>Because this device incorporates parts of various lengths it has a number of advantages over other internal devices for extensive maxillary distraction.

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