Department of Oral and Maxillofacial Surgery, Institute of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan.
Mohri Orthodontic Office, 2-2-7 Kasuga, Tsukuba, Ibaraki, 305-0821, Japan.
J Craniofac Surg. 2023 Sep 1;34(6):1867-1871. doi: 10.1097/SCS.0000000000009412. Epub 2023 May 30.
Anterior maxillary distraction osteogenesis (AMDO) surgery for cleft lip and palate involves distraction of a segment of the anterior maxilla and advancement using 2 intraoral buccal bone-borne distraction devices. The anterior part of the maxilla is advanced anteriorly with less relapse which increases maxillary length and does not affect speech. We aimed to evaluate the effects of AMDO, including lateral cephalometric changes. Seventeen patients who had undergone this procedure were included in this retrospective study. The distractors were activated by 0.5 mm twice a day after a 3-day latency period. Lateral cephalometric radiographs were evaluated preoperatively, after distraction and removal of distractors, which were compared using the paired Student's t test. Anterior maxillary advancement was obtained in all patients with a median of 8.0 mm. Complications included nasal bleeding and loosening of distractors; however, there was no tooth damage or abnormal movement. The mean sella-nasion-A point (SNA) angle increased significantly, from 74.91° to 79.66°, the A point-nasion-B point angle from -0.38° to 4.34°, and the perpendicular line from nasion to Frankfort Horizontal (NV)-A point from -5.11 to 0.08 mm. The mean anterior nasal spine-posterior nasal spine length increased significantly from 50.74 to 55.10 mm, and the NV-Nose Tip from 23.59 to 26.27 mm. The mean relapse rate of NV-A was 11.1%. AMDO with bone-borne distractor resulted in less relapse and effectively corrected the maxillary retrusion.
上颌前牵引术（AMDO）用于唇腭裂患者，涉及前上颌骨的牵引和使用 2 个口腔颊骨骨内牵引器推进。上颌骨的前部分被向前推进，复发率较低，从而增加了上颌长度，且不影响言语功能。我们旨在评估 AMDO 的效果，包括侧颅面变化。本回顾性研究纳入了 17 例接受该手术的患者。在潜伏期 3 天后，每天两次以 0.5 毫米的速度激活牵开器。在术前、牵引后和去除牵开器后评估侧颅面射线照相，并使用配对学生 t 检验进行比较。所有患者均获得了前上颌骨的前向推进，中位数为 8.0 毫米。并发症包括鼻出血和牵开器松动，但无牙齿损伤或异常运动。平均蝶鞍-前颅底点（SNA）角显著增加，从 74.91°增加到 79.66°，A 点-前颅底点-B 点角从-0.38°增加到 4.34°，从鼻根到法兰克福水平面（NV）-A 点的垂直线从-5.11 毫米减少到 0.08 毫米。前鼻嵴-后鼻嵴长度的平均值从 50.74 毫米显著增加到 55.10 毫米，而 NV-鼻尖从 23.59 毫米增加到 26.27 毫米。NV-A 的平均复发率为 11.1%。骨内牵开器的 AMDO 导致较少的复发，并有效地矫正了上颌后缩。
