Orthognatic surgery options in treatment of cleft lip and palate with the use of distraction osteogenesis
Journal Title: Journal of Stomatology (Czasopismo Stomatologiczne) - Year 2013, Vol 66, Issue 3
Abstract
Introduction. Anteroposterior maxillary deficiency occurs frequently in patients with cleft lip and palate. The treatment of patients with primary and secondary cleft palate is usually long-term and involves the stimulation of the maxilla to advance forward in the period of patient’s growth by means of orthodontic and orthopedic methods. The use of a facial mask is one of the applied methods. If there is no improvement, the next stage involves orthodontic-surgical method – distraction osteogenesis where mask may serve as an external distractor. The aim of the study. To discuss skeletal deformities in a patient with cleft lip and palate treated with orthodontic-surgical method with the use of facial mask. Material and method. The presented case concerns an adult patient who, during the growth period had been diagnosed with deficiency of subnasal area, prominent chin and reverse overbite for incisors, which indicated maxillary deficiency confirmed by cephalometric examination. After orthodontic preparation with fixed orthodontic appliances, the method of distraction osteogenesis with the use of facial mask was applied. The comparative analysis was performed 11 years after distraction. Results. The treatment results were evaluated on the basis of photographic documentation, occlusal conditions and cephalometric examination at three intervals: prior to treatment (T0), after active distraction (T1) and 11 years after distraction (T2). The protrusion of maxilla in relation to the cranial base was obtained. The analysis of results 11 years after active distraction showed stable effect of maxillary protraction and improvement of facial profile. Conclusion. On the basis of available literature and own longitudinal observations, it may be concluded that the use of distraction osteogenesis with facial mask as distraction in the treatment of maxillary deficiency in cleft patients is beneficial.
Authors and Affiliations
Dorota Cudziło, Barbara Obłoj
Keywords
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