Management of severe maxillary deficiency through distraction osteogenesis with external distraction device

Objective: To demonstrate a practical method for advancement of the midface using Le Fort I osteotomy and gradual distraction technique.

Methods: With the use of an external adjustable, rigid distraction device, we treated 6 patients with severe maxillary hypoplasia. Ages ranged from 11 to 15 years. They all underwent modified Le Fort I osteotomies assisted by gradual distraction. Four days postoperatively, distraction began at the rate of 1 mm/day for about 2 weeks. 4 weeks with the fixed distraction appliance and 6 weeks with a removable night-time face-mask retention, we then analyzed all those preoperative and postoperative protocols.

Results: Predictable results were obtained. Midface advancement ranged from 8 to 13 mm. A satisfactory class I or II molar relationship is achieved. The aesthetic results are excellent. Up to now, no relapses have been observed.

Conclusions: This method of modified Le Fort I midface advancement has been shown to be clinically practical and effective.