Skeletal, dental and facial aesthetic changes following anterior maxillary segmental distraction by tooth-borne device in patients with cleft lip and palate. Issue 6 (June 2021)

• Record Type: Journal Article
• Authors: Zhang, Z.; Zhang, P.; Li, S.; Cheng, J.; Yuan, H.; Jiang, H.
• Is Part Of: International journal of oral & maxillofacial surgery. Volume 50:Issue 6(2021)
• Page Start: 774
• Page End: 781
• Publication Date: 2021-06
• Subjects: AMSDO -- cleft lip and palate -- maxillary hypoplasia -- dental crowding -- facial aesthetic; Mouth -- Surgery -- Periodicals; Maxilla -- Surgery -- Periodicals; Dentistry -- Periodicals; Dentistry, Operative; Oral Surgical Procedures; Surgery, Oral; Dentistry; Maxilla -- Surgery; Mouth -- Surgery; Electronic journals; Periodicals; 617.52059
• DOI: 10.1016/j.ijom.2020.09.010
• Languages: English
• ISSNs: 0901-5027

Abstract

Abstract: Maxillary skeletal deficiency secondary to cleft lip and palate (CLP) remains a significant challenge. The aim of this study was to present the comprehensive skeletal, dental and facial aesthetic outcomes of anterior maxillary segmental distraction osteogenesis (AMSDO) for treatment of maxillary hypoplasia in patients with CLP. Twelve patients with maxillary hypoplasia treated with AMSDO by a customized tooth-borne distractor were included. Three-dimensional changes of anterior maxillary segment, upper incisor and pharyngeal space were measured by three-dimensional reconstruction derived from cone beam computed tomography (CBCT) data. Length and width of dental arch during distraction were determined in dental casts. Nasolabial angle, soft-tissue convexity and patient's subjective satisfaction were assessed to evaluate facial aesthetic improvements. Nasopharyngoscopic evaluation and speech assessment were also performed before and after distraction. All patients successfully received AMSDO without serious complications. Following AMSDO, the anterior maxillary segments moved forward 5.56 ± 0.28 mm and slightly upward 1.15 ± 0.13 mm. AMSDO significantly lengthened maxillary dental arch, generated new bone to relieve dental crowding and improved patients' facial aesthetic without worsening velopharyngeal closure and speech quality. AMSDO by tooth-borne distractor is an effective surgical alternative for the advancement in patients with cleft maxillary hypoplasia.