Treatment of maxillary hypoplasia in cleft lip and palate: segmental distraction osteogenesis with hyrax device

Abstract

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.