Treatment of Maxillary Hypoplasia in Cleft Lip and Palate: Segmental Distraction Osteogenesis With Hyrax Device.

The objective of this work is to describe a segmental maxillary distraction osteogenesis (SDO) with segmental Lefort I with an inexpensive device. Four patients who presented severe class III and maxillary hypoplasia due to cleft lip and palate sequel were treated. A SDO was performed using a dental-anchored Hyrax device, achieving enlargement of the upper jaw without altering speech, with adequate and stable occlusion. Dental implants in a new formed bone were installed. The authors can conclude that SDO is a good treatment alternative for patients with maxillary hypoplasia. It preserves velopharyngeal function and is a stable treatment, maintaining the overjet achieved with distraction osteogenesis, without changes in posterior occlusion. The open bite generated with tooth-borne devices can be solved with temporary anchorage devices and intermaxillary elastics during consolidation phase. Modified Hyrax device allows expanding and moving forward the maxillary arch, with a low cost. (C) 2017 by Mutaz B. Habal, MD.

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