Sinha Ramen, Menon P Suresh, Venugopal M G
Professor and Vice Principal, Sri Sai Dental College, Vikarabad, Andhra Pradesh.
Professor and HOD, Department of Oral and Maxillofacial Surgery, Vydehi Institute of Dental Sciences, Whitefield, Bangalore.
Med J Armed Forces India. 2011 Jul;67(3):245-52. doi: 10.1016/S0377-1237(11)60051-8. Epub 2011 Aug 7.
Cleft lip and palate patients present large osseous defects of the alveolus and midface hypoplasia. Traditional orthognathic surgery has limitations of relapse and limited age group. Distraction osteogenesis (DO) as a modality for midface advancement is relatively new. Modular internal distractor (MID) offers the advantage of patient compliance and minimal discomfort. The purpose of this study was to evaluate the versatility of intraoral distractors in midface advancement.
Nineteen patients with midface bone stock deficiency were selected for maxillary advancement. At the first surgery under general anaesthesia, after the osteotomy (Le Fort I/II), MID system was used. After distraction, evaluation was done for ease of the procedure, stability, and complications. Lateral cephalograms were evaluated at three stages: T1, pre-distraction; T2, post-distraction; and T3, one year post-distraction.
Significant changes showed 13.3 mm mean midface advancement bone formation at the pterygomaxillary region. The results were stable even at one year follow-up.
Maxillary position improved in relation to the cranial base. This study showed that the MID was versatile in midface advancement in stability and patient compliance with minimal complications.
唇腭裂患者存在牙槽骨大的缺损以及面中部发育不全。传统正颌手术存在复发的局限性且适用年龄组有限。牵张成骨术（DO）作为一种面中部前移的方式相对较新。模块化内置牵张器（MID）具有患者依从性好和不适感最小的优点。本研究的目的是评估口腔内牵张器在面中部前移中的多功能性。
选择19例面中部骨量不足的患者进行上颌前移。在全身麻醉下的首次手术中，截骨（Le Fort I/II）后使用MID系统。牵张后，对手术的简易程度、稳定性和并发症进行评估。在三个阶段评估头颅侧位片：T1，牵张前；T2，牵张后；T3，牵张后一年。
显著变化显示翼上颌区域平均面中部前移骨形成13.3毫米。即使在一年的随访中结果也很稳定。
上颌相对于颅底的位置得到改善。本研究表明，MID在面中部前移中在稳定性、患者依从性和并发症最少方面具有多功能性。
