Maxillary distraction osteogenesis: A method with skeletal anchorage

Maxillary distraction osteogenesis is a challenging technique to treat seve re maxillary retrusion. Maxillary advancement by distraction has the advant age to provide new bone in combination with simultaneous expansion of the s oft-tissue functional matrix. Cleft lip and palate patients can present wit h severe maxillary retrusion and Class III malocclusion. Two 13-year-old pa tients, born with nonsyndromic cleft lip and palate, underwent maxillary di straction-one had a bilateral, the other a unilateral complete cleft lip an d palate. Maxillary advancement was performed using an external distraction device in combination with titanium miniplates as a skeletal maxillary anc horage. After a complete Lefort I osteotomy with pterygomaxillary disjuncti on, a latency period of 3 days was respected. On the fourth postoperative d ay, distraction was initiated at the rate of 1mm/d. Preoperative clinical p hotographs, dental casts, lateral cephalograms, and panoramic radiographs w ere taken. Further lateral cephalograms were obtained after the latency per iod, after completion of the active period of distraction, at the completio n of the consolidation period, and at 6 and 12 months postoperatively. The aesthetic outcome was excellent and skeletal advancement of 8 and 7 mm was measured without dentoalveolar compensations.