Maxillary distraction osteogenesis for correction of maxillary retrognathia in cleft lip and palate patients: a case series

The treatment protocol of patients having maxillary retrognatia is presented in this case series. Maxillary expansion, secondary alveolar bone grafting and/or oronasal fistula closure were performed in 6 cleft lip and palate patients. Preoperative simulation of Le Fort I osteotomy and adaptation of maxillary distractors were realized with stereolytographic cranium models. Intraoral maxillary distraction was applied under general anesthesia. A single unit acrylic occlusal splint was ligated to maxillary dental arch and worked as a guide during entire activation and consolidation period of distraction osteogenesis. Rigid internal fixation plates were placed in the osteotomy sites at the end of consolidation period. The amount of maxillary advancement was between 5-14 mm. Satisfying occlusal and skeletal relationships were obtained in all patients. Advancement of maxilla by distraction osteogenesis resulted in gradual formation of bone at the osteotomy line and enhanced treatment outcome in patients with cleft lip and palate.