Cortese Antonio, Savastano Mauro, Cantone Antonio, Claudio Pier Paolo
Department of Medicine and Surgery, University of Salerno, Italy.
J Craniofac Surg. 2013 Jul;24(4):1341-6. doi: 10.1097/SCS.0b013e31828041a7.
A new palatal distractor device for bodily movement of the maxillary bones after complete segmented Le Fort I osteotomy for 1-stage transversal distraction and tridimensional repositioning on 1 patient is presented. The new distractor has an intrinsic tridimensional rigidity also in the fixation system by self-locking miniplates and screws for better control of the 2 maxillary fragments during distraction.
Le Fort I distraction and repositioning procedure in association with a bilateral sagittal split osteotomy were performed on 1 patient with complete solution of the cross-bite and class III malocclusion. Results of dental and cephalometric analysis performed before surgery (T1), after surgery and distraction time (T2), and 18 months after surgery and orthodontic appliance removal (T3) are reported.
No complications were encountered using the new distractor device. Advantages of this device and technique are presented including improved rigidity of both distraction (jackscrew) and fixation (4 self-locking miniplates and screws) systems resulting in complete control of the position of the 2 maxillary fragments during distraction and surgery. In addition, this new device allows resuming palatal distraction in the event of cross-bite relapse without causing dental-related problems or the risks of screw slackening.
介绍了一种新型腭部牵张器,用于1例患者在完成分段式Le Fort I截骨术后对上颌骨进行整体移动,以实现一期横向牵张和三维重新定位。这种新型牵张器在固定系统中也具有内在的三维刚性,通过自锁微型钢板和螺钉,在牵张过程中能更好地控制两个上颌骨片段。
对1例患者实施了Le Fort I牵张和重新定位手术,并结合双侧矢状劈开截骨术,完全解决了反牙合和III类错牙合问题。报告了术前(T1)、术后及牵张期(T2)、术后18个月及拆除正畸矫治器后(T3)进行的牙齿和头影测量分析结果。
使用新型牵张器未出现并发症。介绍了该器械和技术的优点,包括牵张(螺旋推压器)和固定(4个自锁微型钢板和螺钉)系统的刚性提高,在牵张和手术过程中能完全控制两个上颌骨片段的位置。此外,这种新型器械在反牙合复发时允许恢复腭部牵张,而不会引起与牙齿相关的问题或螺钉松动的风险。