구내 신장술 장치(Internal distraction device)를 이용한 구순구개열 환자의 치료
Treatment for the cleft lip & palate patient using internal distraction device
서희복, 경희문, 박효상, 홍미희,
소속 상세정보
서희복 ( Seo Hee-Bok ) - 경북대학교 치의학전문대학원 치과교정학교실
경희문 ( Kyung Hee-Moon ) - 경북대학교 치의학전문대학원 치과교정학교실
박효상 ( Park Hyo-Sang ) - 경북대학교 치의학전문대학원 치과교정학교실
홍미희 ( Hong Mi-Hee ) - 경북대학교 치의학전문대학원 치과교정학교실
KMID : 0952820170200020021
Abstract
The advantages of distraction osteogenesis for maxillary hypoplasia due to cleft lip and palate are as follows; soft tissue is gradually elongated along with hard tissue, bone graft is not necessary, and postoperative recurrence tendency is reduced. The internal distraction device is more aesthetic and comfortable than the external device. Despite the limited amount of forward advancement, it can be effectively used up to 10-15mm advancement. In this case report, we report distraction osteogenesis of maxilla using internal distraction device for the cleft lip and palate patient with maxillary growth deficiency. Lefort I osteotomy and Zurich distractor fixation surgery was performed. As the initial stability after bone distraction is very low, overcorrection in extension is essential. We instructed the patient to rotate the distraction rod two times a day for 11 days after a latency period of 5 days. We were able to confirm that the amount of maxillary forward movement occurred on lateral cephalograms was sufficient, including overcorrection to prevent relapse. However, by the counterclockwise rotation of the maxilla during distraction, anterior open bite has occurred. Overbite was improved by using intermaxillary elastics. Because it is difficult to correct the direction of the distraction, careful preoperative planning, precise device placement, and close observation during osteogenesis are necessary. Overcorrection should be considered to prevent potential sequelae.
키워드
Cleft lip and palate; maxillary hypoplasia; distraction osteogenesis; internal device; Zurich distractor; RP model
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