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doi: 10.1597/03-152.1
The Cleft Palate-Craniofacial Journal: Vol. 42, No. 3, pp. 318–326.

Rigid External Distraction Using Skeletal Anchorage to Cleft Maxilla United With Alveolar Bone Grafting
Hiroki Kita, D.D.S., Ph.D.
Shoko Kochi, D.D.S., Ph.D.
Yoshimichi Imai, M.D.
Atsushi Yamada, M.D., Ph.D.
Tai Yamaguchi, D.D.S., Ph.D.

Dr. Kita is an Orthodontist and Assistant Professor, Health Administration Center, Tohoku University. Dr. Kochi is an Orthodontist and Associate Professor, Clinics for Maxillo-Oral Disorders, Tohoku University Hospital. Dr. Imai is a Plastic Surgeon and Assistant Professor, and Dr. Yamada is a Plastic Surgeon and Professor, Department of Plastic and Reconstructive Surgery, Tohoku University Graduate School of Medicine. Dr. Yamaguchi is an Oral Surgeon and Chief, Department of Dentistry and Oral Surgery, Sendai National Hospital, Sendai, Japan

Submitted November 2003; Accepted May 2004.

Objective: Documentation of the application of maxillary distraction osteogenesis using rigid external distraction (RED) with skeletal anchorage combined with predistraction alveolar bone grafting (ABG) in cleft maxilla.

Design: Case report.

Patient: A patient with numerous congenital missing teeth and severe maxillary deficiency related to complete bilateral cleft lip and palate with large alveolar bone defect.

Intervention: The patient received preoperative orthodontic treatment, predistraction ABG, and maxillary distraction osteogenesis using RED with skeletal anchorage.

Results: Predistraction ABG completely united the cleft maxilla. The united maxilla was successfully advanced by the RED system with skeletal anchorage, despite unsound dentition with numerous congenital missing teeth.

Conclusion: The present study demonstrates that the combination of predistraction ABG and RED system with skeletal anchorage is effective for the treatment of severe maxillary deficiency related to complete bilateral cleft lip and palate with large bone defect and numerous congenital missing teeth.

KEY WORDS:alveolar bone grafting, cleft lip and palate, distraction osteogenesis, rigid external distraction, skeletal anchorage

© 2005, The American Cleft Palate-Craniofacial Association