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唇腭裂患者上颌骨发育不全的治疗:使用Hyrax装置进行节段性牵张成骨术

Treatment of Maxillary Hypoplasia in Cleft Lip and Palate: Segmental Distraction Osteogenesis With Hyrax Device.

作者信息

Fariña Rodrigo, Diaz Alejandro, Pantoja Roberto, Bidart Carolina

机构信息

Maxillofacial Department, School of Dentistry, University of Chile.

Department of Maxillofacial Surgery, Hospital del Salvador.

出版信息

J Craniofac Surg. 2018 Mar;29(2):411-414. doi: 10.1097/SCS.0000000000004118.

Abstract

The objective of this work is to describe a segmental maxillary distraction osteogenesis (SDO) with segmental Lefort I with an inexpensive device.Four patients who presented severe class III and maxillary hypoplasia due to cleft lip and palate sequel were treated. A SDO was performed using a dental-anchored Hyrax device, achieving enlargement of the upper jaw without altering speech, with adequate and stable occlusion. Dental implants in a new formed bone were installed.The authors can conclude that SDO is a good treatment alternative for patients with maxillary hypoplasia. It preserves velopharyngeal function and is a stable treatment, maintaining the overjet achieved with distraction osteogenesis, without changes in posterior occlusion. The open bite generated with tooth-borne devices can be solved with temporary anchorage devices and intermaxillary elastics during consolidation phase. Modified Hyrax device allows expanding and moving forward the maxillary arch, with a low cost.

摘要

这项工作的目的是描述一种使用廉价装置进行节段性上颌骨牵张成骨术(SDO)并结合节段性勒福Ⅰ型截骨术。对4例因唇腭裂后遗症导致严重Ⅲ类错颌畸形和上颌骨发育不全的患者进行了治疗。使用牙锚式Hyrax装置进行SDO,实现了上颌骨扩大,且不影响语音,咬合良好且稳定。在新形成的骨中植入了牙种植体。作者可以得出结论,SDO是上颌骨发育不全患者的一种良好治疗选择。它保留了腭咽功能,是一种稳定的治疗方法,能维持牵张成骨术所获得的覆盖,后牙咬合无变化。在巩固阶段,通过临时锚固装置和颌间弹力牵引可以解决牙支持式装置产生的开颌问题。改良的Hyrax装置能够以低成本使上颌牙弓扩展并向前移动。

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