Evaluation of Reduction in Relapse and Enhancement of Patient Compliance with Hybrid Technique of Maxillary Distraction Osteogenesis: A Long-term Study

ABSTRACT Introduction and objectives Hybrid technique of maxillary distraction osteogenesis is the latest advance introduced to correct maxillary hypoplasia in cleft lip and palate patients. The objectives of this study was to clinically and cephalometrically evaluate the stability of advanced maxilla over a period of 3 years, after maxillary advancement with hybrid technique of distraction osteogenesis in cleft lip and palate patients, and to asses the patient compliance during the procedure. Materials and methods Ten cleft lip and palate patients having severe maxillary hypoplasia underwent surgical correction of maxillary hypoplasia using hybrid technique of distraction osteogenesis where the rigid external distraction device was immediately removed after the active distraction period, and the advanced maxilla was fixed with rigid internal fixation. Clinical and cephalometrical analyses of the craniofacial skeleton were done at the predistraction, after active distraction and 3 years postdistraction period. Results The results of the clinical and cephalometrical evaluation indicated that there was an effective horizontal advancement of maxilla, increase in the length of the maxilla and a positive correction of overjet all together esthetically improving the facial profile. Three years post distraction evaluation of both the hard and soft tissue profiles indicated a very minimal relapse. All the patients had greater level of compliance after the removal of rigid external distractor and fixation of the distracted maxilla. Conclusion This study concluded that hybrid technique of maxillary distraction osteogenesis in cleft lip and palate patients gave esthetically acceptable facial profile with minimal relapse after 3 years of follow-up and an increased level of patient compliance during the procedure.