Can Use of Rigid Fixation after Consolidation Benefit Cleft Patients following Distraction Osteogenesis?

Publication date: Available online 16 October 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Reza Tabrizi, Kemal Tumer, Shervin Shafiei, Ashkan Rashad
PurposeStability of distraction osteogenesis (DO) is an important issue in maxillary advancement of cleft lip and palate (CLP) patients. The aim of this study was to evaluate postoperative stability between patients with and without internal fixation after removing maxillary distraction devices.Materials and MethodsThis randomized clinical trial assessed CLP patients who needed maxillary advancement of more than 6 mm; they were randomly assigned to two groups. In group 1, distraction devices were removed 3 months after distraction and then we placed 4 L miniplates bilaterally in the maxilla. In group 2 (controls), no miniplates were placed after removing distraction devices. By using lateral cephalograms taken on 3 occasions (preoperatively, immediately after removing the distraction device and 18 months after), the vertical and horizontal changes at the A point were determined.ResultsTwenty-two patients were studied in two groups (11 patients in each group). There was no significant difference between the groups for horizontal relapse (P=0.79). The results did not reveal any significant difference for vertical relapse between the two groups (P=0.11). The Pearson's correlation test demonstrated a correlation between the amount of advancement and the horizontal relapse at the A point in group 1 (P=0.01) and in group 2 (P=0.001). In group 1, for every 1 mm maxillary advancement, 0.36 mm relapse was seen (B=0.36, P=0.01). In group 2, for every 1 mm maxillary advancement, 0.43 mm relapse was seen (B=0.43, P=0.001).ConclusionAccording to our results, rigid fixation after consolidation did not increase stability in CLP patients following DO.



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