Segmental Maxillary Distraction Osteogenesis With a Hybrid-Type Distractor in the Management of Wide Alveolar Cleft.

Objective: To investigate segmental maxillary distraction osteogenesis (DO) with hybrid-type distractor in the management of wide alveolar cleft. Patients and Methods: Six patients underwent segmental DO with a hybrid-type distractor. After the success of DO and 3-month consolidation period, removal of the distractor was accompanied by alveolar bone graft with iliac bone. Panoramic radiograph and computed tomography scanning were taken preoperatively (T0) and the day after distractor removal (T1). The crest distance between the long axis of cleft nearby teeth was measured. Result: All patients completed the DO period, and the succeeding alveolar bone graft healing was uneventful. The mean cleft distance decrease was 12.05 mm (range: 10.1-13.5 mm). As for the mobility degree record of abutment tooth in the transport segment recorded, 6 patients were grading I degrees at T0, while 5 patients were grading I degrees and 1 patient was grading II degrees at T1. Conclusion: Segmental maxillary DO with the hybrid-type distractor is successful to reduce the cleft width in these cases, and it is promising in the treatment of wide dental alveolar cleft, especially for the adult patient.