ORIGINAL ARTICLE   

Minerva Stomatologica 2018 June;67(3):117-24

DOI: 10.23736/S0026-4970.18.04121-3

Copyright © 2018 EDIZIONI MINERVA MEDICA

lingua: Inglese

Tooth-borne distraction osteogenesis versus conventional Le Fort I in maxillary advancement of cleft lip and palate patients

Abdolreza JAMILIAN ¹ ✉, Rahman SHOWKATBAKHSH ², Mohammad BEHNAZ ², Alireza GHASSEMI ³, Zinat KAMALEE ⁴, Letizia PERILLO ⁵

¹ Department of Orthodontics, Tehran Dental Branch, Craniomaxillofacial Research Center, Islamic Azad University, Tehran, Iran; ² Department of Orthodontics, Dentofacial Deformities Research Center, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran; ³ Department of Oral, Maxillofacial Plastic and Reconstructive Surgery, University Hospital, RWTH-Aachen, Germany; ⁴ National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran; ⁵ Unit of Orthodontics, Multidisciplinary Department of Medical-Surgical and Dental Specialties, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy

BACKGROUND: Distraction osteogenesis (DO) is rapidly becoming a mainstream surgical technique for correction of maxillary deficiency. The aim of this study was to compare the effectiveness of a newly designed tooth-borne osteogenic distraction device with conventional Le Fort 1 osteotomy in maxillary advancement of cleft lip and palate patients.
METHODS: The DO group consisted of 10 subjects (7 males, 3 females) with a mean age of 21.2 (SD 4.2) years. In these patients, the newly designed distraction device which exerted force anteroposteriorly was cemented after mobilization of the maxilla. After a latency period of 7 days, the distractor was activated twice daily by a total amount of 0.5 mm per day. The activation was continued for 3 weeks. After an 8-week consolidation period, the distraction appliance was removed. Cephalograms of DO patients were obtained at the start of distraction and at the end of consolidation. The Le Fort 1 group consisted of 11 subjects (6 males, 5 females) with a mean age of 22.3 (SD 3.7) years. Pre and postsurgery lateral cephalograms were obtained. t-test and paired t-test were used to evaluate the data.
RESULTS: At the end of treatment, the SNA angle of Le Fort 1 patients increased by 5.5° (SD 2.3) (P<0.001) and the SNA angle of DO patients increased by 3.4° (SD 2) (P<0.001).
CONCLUSIONS: Current evidence suggests that both conventional Le Fort 1 and tooth-borne osteogenic distraction device can effectively advance the maxilla forward in patients with cleft lip.

KEY WORDS: Cleft palate - Osteogenesis, distraction - Osteotomy, Le Fort