Alveolar Distraction Osteogenesis in Wide Alveolar Cleft Patients

Yıl 2023, Cilt: 2 Sayı: 1, 16 - 19, 20.01.2023

Yavuz Fındık , Doç. Dr. Timuçin Baykul , Mehmet Fatih Şentürk , Tayfun Yazıcı , Betül Kıran

Öz

Introduction
Secondary alveolar cleft repair is commonly accepted for alveolar cleft patients, however, nowadays, controversy remains
regarding the surgical technique, the timing of the surgery, and the donor site. Rehabilitation of the large alveolar clefts with
autogenous graft or distraction osteogenesis is one of the most common treatment choices. The purpose of the report is to
evaluate the surgical techniques for repairing the wide alveolar clefts.
Cases
Four patients with alveolar clefts were included in our case series. The width of the cleft was between 17 to 25 mm. All patients
were treated with distraction osteogenesis. The segmental osteotomy was performed under general anesthesia. Distraction
was started 5 days after surgery. All distractors were bone fixed but supported by a palatal arch for guiding the distraction.
Dental cast models were used before the surgery. Pre and postoperative radiological examinations were performed through
orthopantomogram and computed tomography (CT) scan.
Results
With distraction techniques, closure of the alveolar cleft was achieved. The desired movements with new bone formation were
attained yet eventful in all cases.
Conclusion
The method of treatments described here is a prospect for treating extremely wide alveolar clefts. Further patients are needed
to assess all effects, side effects, risks, and overall benefits of these techniques.

Anahtar Kelimeler

alveolar cleft, distraction osteogenesis, wide cleft

Kaynakça

• 1. Wang XX, Wang X, Li ZL, Yi B, Liang C, Jia YL, Zou BS. Anterior maxillary segmental distraction for correction of maxillary hypoplasia and dental crowding in cleft palate patients: a preliminary report. Int J Oral MaxillofacSurg 2009;38:1237-43.
• 2. Zemann W, PichelmayerM.Maxillary segmental distraction in children with unilateral clefts of lip, palate, and alveolus. Oral Surg Oral Med Oral Pathol Oral RadiolEndod. 2011 Jun;111(6):688-92.
• 3. Ilizarov GA, Lediov VL, Shitin VP. The course of compact bone reparative regeneration in distraction osteosynthesis under different conditions of bone fragment fixation and experimental study. Eksp Khir Anesteziol1969;14:3–12. (in Russian).
• 4. Polley JW, Figueroa AA. Management of severe maxillary deficiency in childhood and adolescence through distraction osteogenesis with an external adjustable rigid distraction device. J Craniofac Surg 1997; 8:181.
• 5. Posnick JC, Tompson B. Cleft-orthognathic surgery: complications and long-term results. Plast Reconstr Surg 1997;96: 255.
• 6. Segmental Maxillary Distraction Osteogenesis With a Hybrid-Type Distractor in the Management of Wide Alveolar Cleft Jianfei Zhang, PhD(c), Wenbin Zhang, PhD, DDS, Steve Guofang Shen, DDS, MD, FICD First Published March 23, 2018
• 7. Picard, A, Diner, PA, Galliani, E, Tomat, C, Vazquez, Mr, Carls, FP. Five years experience with a new intraoral maxillary distraction device (RID). Br J Oral Maxillofac Surg. 2011;49(7):546–551.
• 8. Liou, EJ, Chen, PK, Huang, CS, Chen, YR. Interdental distraction osteogenesis and rapid orthodontic tooth movement: a novel approach to approximate awide alveolar cleft or bony defect. Plast Reconstr Surg. 2000;105(4):1262– 1272.
• 9. Liou EJW, Chen PKT. Intraoral distraction of segmental osteotomies and miniscrews in management of alveolar cleft. Semin Orthod 2009;15:257–67.
• 10. Liou EJ, Chen PKT. Management of maxillary deformities in growing cleft patients. In: Berkowitz S, editor. Cleft Lip and Palate: Diagnosis and Management. Berlin Heidelberg, Germany: Springer-Verlag; 2006.
• 11. Erverdi N, Küçükkeleş N, Şener C, Selamet BU. Interdental distraction osteogenesis for the management of alveolar clefts: archwise distraction. Int J Oral Maxillofac Surg. 2012 Jan;41(1):37-41.
• 12. L. K. Cheung, Q. Zhang, Z. G. Zhang, and M. C. M. Wong, “Reconstruction of maxillectomy defect by transport distraction osteogenesis,” Int J Oral Maxillofac Surg, vol. 32, no. 5, pp. 515–522, 2003.
• 13. N Shahab, DDS, MSc, C Sar, DDS, PhD, M Sarac, DDS, PhD, N Erverdi, DDS, PhD Reconstruction of Premaxilla With Alveolar Distraction Osteogenesis in a Patient With Complete Cleft Lip and Palate: A Case Report. The Cleft Palate-Craniofacial Journal 1-4, 2018.
• 14. Ding Y, Liu Y, Caob M, Maa Q, Zhoua H, Liu B. Periodontal tissues changes in toothborne distraction osteogenesis: an experimental study of closure of wide alveolar bone defects in dogs. Br J Oral Maxillofac Surg 2009;47:111–5.