牵引成骨术治疗青少年上颌骨严重发育不足的初步报告

目的 通过青少年上颌骨严重发育不足，特别是继发于唇腭裂术后严重畸形者行改良Ｌｅ Ｆｏｒｔ Ｉ型截骨，并通过颅骨外固定上颌骨牵引成骨前移术，对牵引成骨后硬组织改建及腭咽闭合功能进行初步探讨。方法 采用颅骨外固定牵引装置（ＫＬＳ－ＭＡＲＴＩＮ公司提供）对６例１１～１５岁唇腭裂术后继发上颌骨严重发育不足及发育性上颌骨严重后缩畸形的青少年实施牵引成骨术。运用正颌外科电脑分析软件对术前、术后头颅定位Ｘ线侧位

Management of severe maxillary deficiency through distraction osteogenesis with external distraction device

OBJECTIVE: To demonstrate a practical method for advancement of the midface using Le Fort I osteotomy and gradual distraction technique. METHODS: With the use of an external adjustable, rigid distraction device, we treated 6 patients with severe maxillary hypoplasia. Ages ranged from 11 to 15 years. They all underwent modified Le Fort I osteotomies assisted by gradual distraction. Four days postoperatively, distraction began at the rate of 1 mm/day for about 2 weeks. 4 weeks with the fixed distraction appliance and 6 weeks with a removable night-time face-mask retention, we then analyzed all those preoperative and postoperative protocols. RESULTS: Predictable results were obtained. Midface advancement ranged from 8 to 13 mm. A satisfactory class I or II molar relationship is achieved. The aesthetic results are excellent. Up to now, no relapses have been observed. CONCLUSIONS: This method of modified Le Fort I midface advancement has been shown to be clinically practical and effective.