Nadjmi N, Schutyser F, Van Erum R
Department of Cranio-Maxillofacial Surgery, Eeuwfeestkliniek, Harmoniestraat 68, B-2018 Antwerpen, Belgium.
Int J Oral Maxillofac Surg. 2006 Oct;35(10):885-96. doi: 10.1016/j.ijom.2006.06.023. Epub 2006 Sep 11.
Maxillary distraction osteogenesis is indicated in severe angle class III malocclusions, and severe maxillary hypoplasia among some cleft patients and other craniofacial deformities. Twenty patients, aged 8-48 years (mean 17.8+/-10.5 SD) with maxillary and midfacial hypoplasia were treated. The follow-up period was 13-65 months (mean 35+/-16.3 SD). A trans-sinusal maxillary distractor was placed intraorally at each side of the maxilla. The distraction vector was predicted using specialist software, and was transferred to the patients using stereolithographic models and individual templates. A (high) Le Fort I type osteotomy was performed. The amount of activation varied from 8 to 17.5 mm (mean 13.1+/-2.9 SD). Soft and hard tissue formation resulted in complete healing across the distraction gaps. The distractors are almost completely submerged, and can be left in place as long as necessary to avoid relapse. Wit's appraisal was used to measure the stability of the long-term distraction results. Results up to 5 years after distraction showed considerable maxillary advancement with long-term stability. Ongoing growth of the facial skeleton must be considered when distraction osteogenesis is chosen in growing patients.
上颌骨牵张成骨适用于严重的安氏III类错牙合畸形、部分腭裂患者及其他颅面畸形中的严重上颌骨发育不全。对20例年龄在8至48岁（平均17.8±10.5标准差）的上颌骨及面中部发育不全患者进行了治疗。随访期为13至65个月（平均35±16.3标准差）。在上颌骨两侧口腔内放置经鼻窦上颌骨牵张器。使用专业软件预测牵张向量，并通过立体光刻模型和个体化模板将其应用于患者。进行了（高位）Le Fort I型截骨术。激活量为8至17.5毫米（平均13.1±2.9标准差）。软硬组织形成使牵张间隙完全愈合。牵张器几乎完全被埋没，可根据需要长期留置以避免复发。采用Wit评估法测量长期牵张结果的稳定性。牵张后长达5年的结果显示上颌骨有显著前移且长期稳定。在生长发育期患者中选择牵张成骨时，必须考虑面部骨骼的持续生长。
