Angle Orthod. 2022 Nov 1;92(6):764-772. doi: 10.2319/020922-118.1.
To evaluate inflammatory mediator levels and periodontal changes following distraction osteogenesis (DO) in patients with cleft lip and palate (CLP) using mid-maxillary distraction (MMD).
A total of 20 healthy patients with CLP with Class III malocclusion were included. Segmental forward advancement of the anterior maxilla from the second premolars on both sides using DO was performed. A custom-made, tooth-borne distractor connecting buccal molar segments to the anterior maxilla was used for 7 days with 0.5-mm distraction for the first 2 days and then increased to 1 mm daily until overcorrection. Crevicular interleukin IL-1β and tumor necrosis factor TNF-α levels were measured during distraction. Periodontal clinical parameters and indices were recorded at baseline and 3 and 6 months postoperatively. Soft tissue healing was evaluated histologically at 2 and 4 weeks after distraction.
The periodontal parameters remained stable during the follow-up periods. Insignificant increases in the level of inflammatory cytokines compared with the control were observed. Histological findings revealed mild inflammatory and structural changes in the gingiva immediately after distraction, whereas regeneration was noticed after 4 weeks.
MMD was an effective technique in treating patients with CLP, leading to new bone and soft tissue formation without significant detrimental effect on the periodontium of the adjacent teeth.
评估唇腭裂（CLP）患者使用中面部牵引（MMD）进行牵张成骨（DO）后的炎症介质水平和牙周变化。
共纳入 20 名患有 III 类错牙合的健康 CLP 患者。使用 DO 从两侧第二前磨牙向前分段推进上颌前部。使用定制的、牙支持的牵开器将颊侧磨牙段连接到上颌前部，在最初的 2 天以 0.5mm 的距离牵开，然后每天增加 1mm，直到矫枉过正。在牵开过程中测量龈沟内白细胞介素 IL-1β 和肿瘤坏死因子 TNF-α 水平。在基线和术后 3 个月和 6 个月记录牙周临床参数和指数。在牵开后 2 周和 4 周进行组织学评估软组织愈合情况。
在随访期间，牙周参数保持稳定。与对照组相比，炎症细胞因子水平仅略有升高。组织学发现，牵开后即刻牙龈有轻度炎症和结构变化，4 周后可见再生。
MMD 是治疗 CLP 患者的有效技术，可导致新骨和软组织形成，而对相邻牙齿的牙周组织无明显不良影响。
