Hirjak D, Reyneke J P, Janec J, Beno M, Kupcova I
Bratisl Lek Listy. 2016;117(12):685-690. doi: 10.4149/BLL_2016_134.
Patients with cleft lip and palate (CLP) related deformities frequently have maxillary hypoplasia in all dimensions. These patients usually present with class III malocclusions, retruded midfaces and narrow hard palates. The skeletal problems can be treated by means of Le Fort I maxillary procedures. Surgical and orthodontic correction of severe maxillary hypoplasia, as often seen in CLP patients, has however proved to be challenging. The magnitude of the advancement is often hampered and the post operative stability significantly affected by palatal soft tissue scarring. The slow distraction of bone and the histogenic abilities of distraction osteogenesis (DO) have made it an atractive alternative treatment option for the management of maxillary hypoplasia in these patients. This paper presents the treatment results of 15 nongrowing CLP patients with severe maxillary hypoplasia treated by means of intra oral distraction. The mean anterior distraction of the maxillas was 12.7 mm (9-15.0 mm). The long-term cephalometric and clinical evaluation after a minimum of 60 months (mean follow-up 71 months) proved to be stable. The treatment results revealed, that distraction osteogenesis in nongrowing CLP patients with severe maxillary hypoplasia proved to be a predictable and stable option (Tab. 2, Fig. 3, Ref. 26).
唇腭裂（CLP）相关畸形患者的上颌骨在各个维度上通常都发育不全。这些患者通常表现为III类错牙合、面中部后缩和硬腭狭窄。骨骼问题可通过勒福I型上颌骨手术进行治疗。然而，对于唇腭裂患者常见的严重上颌骨发育不全，手术和正畸矫正已被证明具有挑战性。上颌骨前移的幅度常常受到阻碍，术后稳定性也会受到腭部软组织瘢痕形成的显著影响。骨的缓慢牵张以及牵张成骨（DO）的组织生成能力使其成为治疗这些患者上颌骨发育不全的一种有吸引力的替代治疗选择。本文介绍了15例非生长发育期唇腭裂严重上颌骨发育不全患者经口内牵张治疗的结果。上颌骨的平均前牵张距离为12.7毫米（9 - 15.0毫米）。至少60个月（平均随访71个月）后的长期头影测量和临床评估结果显示情况稳定。治疗结果表明，对于非生长发育期唇腭裂严重上颌骨发育不全患者，牵张成骨是一种可预测且稳定的治疗选择（表2，图3，参考文献26）。
