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ORIGINAL ARTICLE - EVALUATIVE STUDY
Year : 2021  |  Volume : 11  |  Issue : 1  |  Page : 49-57

Accuracy of virtually planned maxillary distraction in cleft patients - An evaluative study


1 Department of Pediatric Surgery, Division of Maxillofacial Surgery, Hospital Sant Joan De Déu; Department of Innovation (3D4H, 3D for Health), Hospital Sant Joan De Déu, Barcelona, Spain
2 Department of Innovation (3D4H, 3D for Health), Hospital Sant Joan De Déu, Barcelona, Spain
3 Department of Pediatric Surgery, Hospital Sant Joan De Déu, Barcelona, Spain
4 Department of Pediatric Surgery, Division of Maxillofacial Surgery, Hospital Sant Joan De Déu, Barcelona, Spain
5 Department of Anesthesiology, Hospital Sant Joan De Déu, Barcelona, Spain
6 Department of Orthodontics, Hospital Sant Joan De Déu, Barcelona, Spain
7 Department of Odontology, Universidad Católica San Antonio, Murcia, Spain
8 Department of Oral Medicine, Universitat Internacional de Catalunya, Spain

Correspondence Address:
Dr. Josep Rubio-Palau
Hospital Sant Joan De Déu: Passeig De Sant Joan De Déu 2. 08950 Esplugues De Llobregat, Barcelona
Spain
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DOI: 10.4103/ams.ams_331_20

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Introduction: Maxillary distraction may be used to treat severe maxillary hypoplasia in cleft lip and palate (CLP) patients. Three-dimensional (3D) planning has been shown to increase the accuracy of distraction and reduce operative time and complications. The aim of the study was to measure the accuracy of internal maxillary distraction after 3D planning in CLP patients, to add evidence to validate the virtual osteotomy and distraction procedure. Materials and Methods: Eleven CLP patients with severe maxillary hypoplasia underwent maxillary distraction using internal distractors. Virtual planning was used to design the osteotomies, the distractor position, and the distraction vector. Cutting and positioning guides transferred this information to the surgical procedure. Four to six month postoperative computed tomography-scan was done before distractor removal; anatomical reference points were compared to the virtual planning to determine accuracy. Results: A high accuracy (point dislocation <1.5 mm) was found in 90% of the points of the surface of the maxilla; the majority of the zygomatic screws were placed within a distance of 0.8–1 mm from their planned position. Discussion: The high accuracy achieved through virtual planning promotes optimal distractor placement; a customized distraction vector has a direct effect on the final position of the maxilla.


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