Background: Distraction Osteogenesis
is popular for long bones. And nowadays it has found its role in facial bone
deficiency treatments. Purpose: We used our special designed Distractor for
advancement of Maxillary deficiencies in cleft lip and palate patients. The
purpose of this paper is to compare the treatment of hypoplastic, posteriorly
retruded maxillary of cleft palate patients using distraction osteogenesis vs.
Le fort I orthognathic surgery for length of advancement, stability and
relapse, growth after distraction and soft tissue expansion and soft tissue
profile changes. Meterial & Methods: In group A only Le fort I and surgical
maxillary advancement sometimes with bone graft were done. In group B we used
our special Distractor for Distraction Osteogenesis and advancement of the
Maxillary bone. Demographic data, length of retrusion of maxilla, time length of
treatment, length of advancement and relapse, SNA and SNB angles were measured
and included in the study. The results were compared in each group before and
after advancement and between both groups. The rate of distraction was 0.5 mm
twice per day to achieve normal occlusion with 2 mm overcorrection more than
calculated measures. The devices removed after 10 weeks as latency period.
Results: The SNA increased at the end of distraction (p < 0.001), with no
significant relapse indicating stability at 1 year after treatment. The total
length of advancement in group A was 17 ± 4 mm and in group B was 20 ± 3 mm.
The difference between before and after measurements in each group was
significant (p = 0.002, p = 0.003 respectively). The mean length of relapse in group
A was 3 ± 1 mm and in group B was 1 mm. Discussion: For the deformities and
retrusions less than 7 - 8 mm, the Orthognatic surgery is the treatment of
choice, however for more retrusions (>10 mm) we recommend Distraction
Osteogenesis, and it preferred to start it soon in younger ages.