Distraction osteogenesis of the maxilla and midface using a subcutaneous device: report of four cases

The use of distraction osteogenesis in the hypoplastic maxilla and midface is still controversial. Since the beginning of 1998, 25 patients have been treated with osteodistraction techniques for various reasons. Among them were four patients who were treated by high LeFort I osteotomies and insertio...

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Published in:British journal of oral & maxillofacial surgery 2001-02, Vol.39 (1), p.13-21
Main Authors: Keßler, P., Wiltfang, J., Schultze-Mosgau, S., Hirschfelder, U., Neukam, F.W.
Format: Article
Language:English
Subjects:
Adolescent
Biological and medical sciences
Child
Dentistry
Female
Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics
Humans
Male
Maxilla - abnormalities
Maxilla - surgery
Maxillofacial Abnormalities - surgery
Maxillofacial surgery. Dental surgery. Orthodontics
Medical sciences
Osteogenesis, Distraction - instrumentation
Secondary Prevention
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Technology. Biomaterials. Equipments
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Summary:The use of distraction osteogenesis in the hypoplastic maxilla and midface is still controversial. Since the beginning of 1998, 25 patients have been treated with osteodistraction techniques for various reasons. Among them were four patients who were treated by high LeFort I osteotomies and insertion of a newly developed subcutaneous distraction device in the malar region. Distraction osteogenesis was successful in all four cases resulting in a mean sagittal bone gain of 12.0 mm (range 7–14) at the level of distractor fixation. All patients were kept under orthodontic supervision during osteodistraction. The final occlusal relation was satisfactory. Cephalometric measurements after distraction showed an anterior rotational movement of the midface region. As the question of relapse and further growth is still not clear, Delaire masks are used to stabilize the surgical result after removal of the distractor. The importance of long-term follow-up is stressed.
ISSN:0266-4356
1532-1940
DOI:10.1054/bjom.2000.0545