2003 Volume 28 Issue 3 Pages 229-237
Objective: This study investigated the change and stability of maxilla through application of distraction osteogenesis using the RED System to patients with cleft lip and palate. Materials and methods: The cases used in this study were 8 cleft lip and palate patients, mean age of 13. 3 years, treated using the RED System at Tokyo Medical and Dental University Hospital. Maxillary movement during the distraction and follow-up periods was investigated, using lateral cephalograms taken before distraction, at the removal of halo, and more than 6 months after surgery. Results: 1. In horizontal dimension, mean maxillary advancement of 9. 4mm, ranged from 4. 0mm to 14. 5mm, was attained during distraction. During the follow-up period, relapse was observed in all cases and the mean amount was 2. 0mm indicating 21. 7% of advancement. A negative correlation was found between horizontal changes in the distraction and follow-up periods. 2. In vertical dimension, maxillary movement was upward in 1 case, downward in 6 cases, and not shown in 1 case during distraction, resulting in a mean amount of 2. 9mm downward. During the follow-up period, maxillary movement was upward in 2 cases, downward in 5 cases, and not shown in 1 case. However, a negative correlation was found between vertical changes in the distraction and follow-up periods, and changes in opposite directions between two periods were demonstrated in only 3 cases. 3. Clockwise and counterclockwise rotation of the palatal plane during the distraction period was observed in 4 cases, respectively, with mean angle of 1. 1 degrees clockwise. A negative correlation was found between rotation of the palatal plane in the distraction and follow-up periods. Conclusion: Distraction osteogenesis using the RED System was applied to patients with cleft lip and palate including growing children. A large maxillary advancement, mean of 9. 4mm, was attained, suggesting the clinical significance of this technique.
