Distraction versus conventional orthognathic procedures in patients with cleft lip and palate. Preliminary results

The purpose of this investigation was to evaluate skeletal stability of advanced maxilla in 21 adolescent and adult patients with cleft lip and palate deformities. We used conventional orthognathic procedures and distraction osteogenesis to correct the retruded maxilla. The maxilla was advanced in the mean 4.1 mm in 13 patients in a bimaxillary procedure. In the one year follow up no relapse was found in these patients. There even was an additional advancement of Point A to 4.8 mm. 4 patients underwent only a Le Fort I osteotomy. Point A was advanced 3.9 mm and relapsed after one year to 3.1 mm. In none of these conventional treated patients bone grafts were inserted. Distraction with an intraoral distractor was done in 4 patients. Advancement of the maxilla at Point A was 6.4 mm and after a mean follow up of 8 months Point A relapsed to 5.8 mm. Long time follow up is necessary to get more information if distraction is an alternative method in Le Fort I advancement.