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Revista Mexicana de Ortodoncia

ISSN 2395-9215 (Print)
Órgano Oficial de Difusión de la Facultad de Odontología de la UNAM
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2014, Number 3

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Rev Mex Ortodon 2014; 2 (3)

Design of an internal distraction device for maxillary advancement in cleft-lip-palate patients

Lazarín EJ, Barceló SFH
Full text How to cite this article

Language: Spanish
References: 10
Page: 163-169
PDF size: 597.72 Kb.


Key words:

Distraction osteogenesis, finite element analysis, cleft lip and palate.

ABSTRACT

Introduction: Cleft lip and palate (CLP) is the most frequent craniofacial defect. (1:1000 newborns). CLP patients present severe maxillary retrusion that require a surgical procedure to advance their maxilla. Distraction osteogenesis is an effective treatment; however available internal maxillary distraction devices present inconveniences. Objective: To design a biocompatible, inexpensive and mechanically efficient prototype of an internal maxillary distraction device. This device should be easy to place and comfortable for the patient. Method: Computed tomography (CT) data of an adult CLP patient was obtained. DICOM files were processed and a stereolitographic (STL) model was printed. Computer aided design (CAD) software was used to design the device and to perform a finite element analysis (FEA) to evaluate the mechanical behavior of the appliance. Finally a prototype was manufactured by a computer aided manufacturing (CAM) process and tested on the STL model. Results: This prototype complied with our requirements for an efficient internal maxillary distraction device. Conclusions: The integration of clinical knowledge with novel technology (CT, STL, CAD, FEA, and CAM) is very useful for the development of medical or dental appliances.


REFERENCES

  1. Rozen Fuller I. Labio y paladar hendido. México: A.R. Kaktus; 2000.

  2. Blanco-Davila F. Incidence of cleft lip and palate in the northeast of México: A 10 year study. J Craniofac Surg. 2003; 14, (4): 533-537.

  3. Mutchinick O. Programa mexicano de registro y vigilancia epidemiológica de malformaciones congénitas externas. Salud Pública de México. 1998; 10: 476-450.

  4. Berkowitz S. Cleft lip and palate. San Diego: Singular Publishing Group; 1996.

  5. Swennen G, Schliephake H, Dempf R. Craniofacial distraction osteogenesis: a review of the literature. Part II: experimental studies. Int J Oral Maxillofac Surg. 2002; 31: 123-135.

  6. Rachmiel A. Treatment of maxillary cleft palate: distraction osteogenesis versus orthognatic surgery-part one: maxillary distraction. J Oral Maxillofac Surg. 2007; 65: 753-757.

  7. Cheung L, Zhang Q, Wong M, Wong L. Stability consideration for internal maxillary distractors. J CranioMaxillofacial Surg. 2003; 31: 142-148.

  8. Kebler P, Wiltfang S, Schultze U, Hirschfelder N. distraction osteogenesis of the maxilla and midface using a subcutaneous device: report of four cases. British J Oral Maxillofac Surg. 2001; 39: 13-21.

  9. Yamaji K, Gateno J, Xia J, Teichgraeber J. New internal le fort I distractor for the treatment of midface hypoplasia. J Craniofac Surg. 2004; 15: 124-127.

  10. Van Sikels J, Madsen M, Cunningham L, Bird D. The use of internal maxillary distraction for maxillary hypoplasia: a preliminary report. J Oral Maxillofac Surg. 2006; 64: 1715-1720.




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Rev Mex Ortodon. 2014;2