Maxillofac Plast Reconstr Surg.  2016 Apr;38(4):20. 10.1186/s40902-016-0069-x.

Long-term follow-up of early cleft maxillary distraction

Affiliations
  • 1Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University, 7 Jukheon-gil, Gangneung, 210-702 South Korea. omfsmk@gwnu.ac.kr

Abstract

BACKGROUND
Most of cleft lip and palate patients have the esthetic and functional problems of midfacial deficiencies due to innate developmental tendency and scar tissues from repeated operations. In these cases, maxillary protraction is required for the harmonious facial esthetics and functional occlusion.
CASE PRESENTATION
A 7-year old boy had been diagnosed as severe maxillary constriction due to unilateral complete cleft lip and palate. The author tried to correct the secondary deformity by early distraction osteogenesis with the aim of avoiding marked psychological impact from peers of elementary school. From 1999 to 2006, repeated treatments, which consisted of Le Fort I osteotomy and face mask distraction, and complementary maxillary protraction using miniplates were performed including orthodontics. But, final facial profile was not satisfactory, which needs compromising surgery.
CONCLUSIONS
The result of this study suggests that if early distraction treatment is performed before facial skeletal growth is completed, an orthognathic surgery or additional distraction may be needed later. Maxillofacial plastic and reconstructive surgeons should notify this point when they plan early distraction treatment for cleft maxillary deformity.

Keyword

Unilateral complete cleft lip and palate; Maxillary constriction; Early distraction treatment

MeSH Terms

Cicatrix
Cleft Lip
Congenital Abnormalities
Constriction
Esthetics
Follow-Up Studies*
Humans
Male
Masks
Orthodontics
Orthognathic Surgery
Osteogenesis, Distraction
Osteotomy
Palate
Plastics
Surgeons
Plastics
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