Transantral distraction devices in correction of severe maxillary deformity in cleft patients.
Transantral distraction devices in correction of severe maxillary deformity in cleft patients.
复制标题
经窦牵引装置矫正唇裂患者的严重上颌畸形。
作者：
Shokhruh Shokirov;K. Wangerin
在唇腭裂患者中，通过Le Fort I截骨术进行上颌骨前移的平均复发率约为40- 60%。使用口外牵引装置，上颌几乎可以无限制地向前推进。由于社会问题，保留期通常缩短至几个月。在这些病例中可以看到10- 25%的复发。Le Fort I内牵引成骨术提供了一种替代一步式正颌前移的方法，其优点是通过瘢痕逐渐延长和对生长期患者进行早期治疗。本研究的目的是介绍我们的经验，在治疗上颌骨缺损的腭裂患者使用经上颌窦内牵引装置。在17例患者中成功完成了牵张手术。17例患者均使用Konrad Wangerin设计的上颌骨牵引装置。牵引距离为8 - 24 mm。术前、术后和随访（12个月和24个月）侧位头颅X线片测量值进行了比较，包括角度和线性变化。在截骨线之间的牵引节段中发现了良好的新骨形成。面部正中区牵张后，软组织的咬合和轮廓得到了显着改善。所有患者术后均需进行最后的正畸治疗，其最终咬合关系令人满意。经上颌窦牵引装置是治疗唇腭裂患者严重上颌骨发育不全的一种新的选择。
Maxillary advancement by Le Fort I osteotomy in cleft patients has an average relapse of about 40-60 percent. With extraoral distraction devices it is possible to obtain an almost unlimited advancement of the upper jaw. Due to the social problems the retention period is normally reduced to some monthes. A relapse of 10-25 % can be seen in these cases. Le Fort I internal distraction osteogenesis offers an alternative to one-step orthognathic advancement, with advantages of gradual lengthening through scar and earlier treatment in growing patients. The objective of this study was to present our experience in the treatment of maxillary deficiency in cleft patients using transantral internal distraction devices. The distraction procedure was successfully accomplished in seventeen patients. For all the seventeen patients maxillary distraction device designed by Konrad Wangerin was used. The distraction distances were 8 to 24 mm. Preoperative, postoperative, and follow-up (12 and 24 months) lateral cephalogram measurements were compared including angular and linear changes. A good new bone was found that was formed in distraction pitch between lines of osteotomy. After distraction of median facial zone, occlusion and profile of soft tissues were considerably improved. All patients after postoperative time required final orthodontic treatment and their final occlusal relationships were satisfactory. The transantral distraction device is a new option for the treatment of severe maxillary hypoplasia in cleft patients.