Distraction osteogenesis of the maxilla and midface using a subcutaneous device: report of four cases

• Published in: British journal of oral & maxillofacial surgery Vol. 39; no. 1; pp. 13 - 21
• Main Authors: Keßler, P., Wiltfang, J., Schultze-Mosgau, S., Hirschfelder, U., Neukam, F.W.
• Format: Journal Article
• Language: English
• Published: Londonc Elsevier Ltd 01-02-2001; Elsevier
• Subjects: Adolescent; Biological and medical sciences; Child; Dentistry; Female; Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics; Humans; Male; Maxilla - abnormalities; Maxilla - surgery; Maxillofacial Abnormalities - surgery; Maxillofacial surgery. Dental surgery. Orthodontics; Medical sciences; Osteogenesis, Distraction - instrumentation; Secondary Prevention; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Technology. Biomaterials. Equipments; Human; Hypoplasia; Stomatology; Subcutaneous; Device; Diseases of the osteoarticular system; Maxillary; Result; Treatment; Equipment; Surgery; Distraction; Technique; Face; Osteogenesis; Maxillary disease
• ISSN: 0266-4356; 1532-1940
• DOI: 10.1054/bjom.2000.0545

The use of distraction osteogenesis in the hypoplastic maxilla and midface is still controversial. Since the beginning of 1998, 25 patients have been treated with osteodistraction techniques for various reasons. Among them were four patients who were treated by high LeFort I osteotomies and insertion of a newly developed subcutaneous distraction device in the malar region. Distraction osteogenesis was successful in all four cases resulting in a mean sagittal bone gain of 12.0 mm (range 7–14) at the level of distractor fixation. All patients were kept under orthodontic supervision during osteodistraction. The final occlusal relation was satisfactory. Cephalometric measurements after distraction showed an anterior rotational movement of the midface region. As the question of relapse and further growth is still not clear, Delaire masks are used to stabilize the surgical result after removal of the distractor. The importance of long-term follow-up is stressed.