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Techniques for the Treatment of Maxillary Hypoplasia in Cleft Patients: An Overview

Received: 5 February 2016     Accepted: 9 February 2016     Published: 16 June 2016
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Abstract

Purpose of review Maxillary hypoplasia is often unavoidable sequelae in cleft lip and palate patients who had undergone timely surgical and orthodontic intervention. Since 1970s these deformities have been traditionally corrected by means of orthognathic surgery. Numerous published studies have tried different techniques to combat the same. The advantages and disadvantages of the various techniques are overviewed. Recent Findings Distraction osteogenesis is one of the recent major developments in the field of oral and maxillofacial surgery and provides promising outcome. Tooth borne device hyrax proved good skeletal stability of distracted anterior maxillary segment. Distraction forces when directly transferred to the bone resulted in significant dentoalveolar compensation. This modern technique has also been used to evaluate its immediate and long term impact on nasal index as well which showed significant increase. This technique overcomes significant disadvantages of relapse and velopharyngeal insufficiency and also helps to produce better normal facial esthetics and profiles and masticatory function. Summary The oral and maxillofacial surgeons have widely accepted the use of maxillary distraction osteogenesis as an attractive alternative to treat malocclusion in CLP patients and this has broadened the reconstructive spectrum. Recent advancements have led to a wider clinical application and improved acceptance.

Published in Science Journal of Clinical Medicine (Volume 5, Issue 4-1)

This article belongs to the Special Issue Clinical Conspectus on Cleft Deformities

DOI 10.11648/j.sjcm.s.2016050401.20
Page(s) 59-63
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2016. Published by Science Publishing Group

Keywords

Distraction Osteogenesis, Maxillary Hypoplasia, Rigid External Device, Le Fort 1 Osteotomy

References
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[2] Scolozzi P. Distraction osteogenesis in the management of severe maxillary hypoplasia in cleft lip and palate patients. J Craniofac Surg. 2008; 19(5): 1199–1214.
[3] Patrick D. Combs, MD and Raymond J. Harshbarger, III. Advancement Using Distraction Osteogenesis Le Fort I Maxillary Semin Plast Surg. 2014 Nov; 28(4): 193–198.
[4] Rachmiel A. Treatment of maxillary cleft palate: distraction osteogenesis versus orthognathic surgery—part one: maxillary distraction. J Oral Maxillofac Surg. 2007; 65(4): 753–757
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[7] Chua H D, Hägg M B, Cheung L K. Cleft maxillary distraction versus orthognathic surgery—which one is more stable in 5 years? Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010; 109(6): 803–814.
[8] Terbish M, Choi HY, Park YC, Yi CK, Cha JY. Premaxillary Distraction Osteogenesis Using an Intraoral Appliance for Unilateral Cleft Lip and Palate: Case Report. Cleft Palate Craniofac J. 2015 Jul; 52(4): e95-e102.
[9] Gao QW, Song HF, Xu MH, Liu CM, Chai JK.. [Mandibular-driven simultaneous maxillo-mandibular distraction for hemifacial microsomia with rapid prototyping technology] Int J Oral Maxillofac Surg. 2009; 35(1): 14–24.
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[13] Figueroa A A, Polley J W. Clinical controversies in oral and maxillofacial surgery: Part two. External versus internal distraction osteogenesis for the management of severe maxillary hypoplasia: external distraction. J Oral Maxillofac Surg. 2008; 66(12): 2598–2604.
[14] Ross R B. Treatment variables affecting facial growth in complete unilateral cleft lip and palate. Cleft Palate J.1987; 24(1): 5–77.
[15] Yu H1, Dai J, Wang X, Zhang W, Shen SG. Le Fort II midfacial distraction combined with orthognathic surgery in the treatment of nasomaxillary hypoplasia. J Craniofac Surg. 2014 May; 25(3): e241-4.
[16] Hettinger PC, Hanson PR, Denny AD. Le Fort III distraction using rotation advancement of the midface in patients with cleft lip and palate.. Plast Reconstr Surg. 2013 Dec; 132(6): 1532-41.
[17] Sakamoto Y, Nakajima H, Tamada I, Sakamoto T. Le Fort IV + I distraction osteogenesis using an internal device for syndromic craniosynostosis J Oral Maxillofac Surg. 2014 Apr; 72(4): 788-95.
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Cite This Article
  • APA Style

    Midhuna Prathap, Varun Menon P. (2016). Techniques for the Treatment of Maxillary Hypoplasia in Cleft Patients: An Overview. Science Journal of Clinical Medicine, 5(4-1), 59-63. https://doi.org/10.11648/j.sjcm.s.2016050401.20

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    ACS Style

    Midhuna Prathap; Varun Menon P. Techniques for the Treatment of Maxillary Hypoplasia in Cleft Patients: An Overview. Sci. J. Clin. Med. 2016, 5(4-1), 59-63. doi: 10.11648/j.sjcm.s.2016050401.20

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    AMA Style

    Midhuna Prathap, Varun Menon P. Techniques for the Treatment of Maxillary Hypoplasia in Cleft Patients: An Overview. Sci J Clin Med. 2016;5(4-1):59-63. doi: 10.11648/j.sjcm.s.2016050401.20

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  • @article{10.11648/j.sjcm.s.2016050401.20,
      author = {Midhuna Prathap and Varun Menon P.},
      title = {Techniques for the Treatment of Maxillary Hypoplasia in Cleft Patients: An Overview},
      journal = {Science Journal of Clinical Medicine},
      volume = {5},
      number = {4-1},
      pages = {59-63},
      doi = {10.11648/j.sjcm.s.2016050401.20},
      url = {https://doi.org/10.11648/j.sjcm.s.2016050401.20},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sjcm.s.2016050401.20},
      abstract = {Purpose of review Maxillary hypoplasia is often unavoidable sequelae in cleft lip and palate patients who had undergone timely surgical and orthodontic intervention. Since 1970s these deformities have been traditionally corrected by means of orthognathic surgery. Numerous published studies have tried different techniques to combat the same. The advantages and disadvantages of the various techniques are overviewed. Recent Findings Distraction osteogenesis is one of the recent major developments in the field of oral and maxillofacial surgery and provides promising outcome. Tooth borne device hyrax proved good skeletal stability of distracted anterior maxillary segment. Distraction forces when directly transferred to the bone resulted in significant dentoalveolar compensation. This modern technique has also been used to evaluate its immediate and long term impact on nasal index as well which showed significant increase. This technique overcomes significant disadvantages of relapse and velopharyngeal insufficiency and also helps to produce better normal facial esthetics and profiles and masticatory function. Summary The oral and maxillofacial surgeons have widely accepted the use of maxillary distraction osteogenesis as an attractive alternative to treat malocclusion in CLP patients and this has broadened the reconstructive spectrum. Recent advancements have led to a wider clinical application and improved acceptance.},
     year = {2016}
    }
    

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    T1  - Techniques for the Treatment of Maxillary Hypoplasia in Cleft Patients: An Overview
    AU  - Midhuna Prathap
    AU  - Varun Menon P.
    Y1  - 2016/06/16
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    N1  - https://doi.org/10.11648/j.sjcm.s.2016050401.20
    DO  - 10.11648/j.sjcm.s.2016050401.20
    T2  - Science Journal of Clinical Medicine
    JF  - Science Journal of Clinical Medicine
    JO  - Science Journal of Clinical Medicine
    SP  - 59
    EP  - 63
    PB  - Science Publishing Group
    SN  - 2327-2732
    UR  - https://doi.org/10.11648/j.sjcm.s.2016050401.20
    AB  - Purpose of review Maxillary hypoplasia is often unavoidable sequelae in cleft lip and palate patients who had undergone timely surgical and orthodontic intervention. Since 1970s these deformities have been traditionally corrected by means of orthognathic surgery. Numerous published studies have tried different techniques to combat the same. The advantages and disadvantages of the various techniques are overviewed. Recent Findings Distraction osteogenesis is one of the recent major developments in the field of oral and maxillofacial surgery and provides promising outcome. Tooth borne device hyrax proved good skeletal stability of distracted anterior maxillary segment. Distraction forces when directly transferred to the bone resulted in significant dentoalveolar compensation. This modern technique has also been used to evaluate its immediate and long term impact on nasal index as well which showed significant increase. This technique overcomes significant disadvantages of relapse and velopharyngeal insufficiency and also helps to produce better normal facial esthetics and profiles and masticatory function. Summary The oral and maxillofacial surgeons have widely accepted the use of maxillary distraction osteogenesis as an attractive alternative to treat malocclusion in CLP patients and this has broadened the reconstructive spectrum. Recent advancements have led to a wider clinical application and improved acceptance.
    VL  - 5
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Author Information
  • Department of ENT, ENT Resident, Kerala University, Sree Gokulam Medical College and Research Foundation, Trivandrum, India

  • Department of Oral and Maxillofacial Surgery, Oral and Maxillofacial Resident, Kerala University, PMS College of Dental Science, Trivandrum, India

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