Assessment of aesthetic and functional improvement of patients with mid-facial hypoplasia corrected using mid maxillary osteodistraction (MMOD) with a tooth-borne distractor

A method of mid maxillary distraction osteogenesis using tooth borne custom-made device is being performed on cleft patients in Oral and Maxillofacial unit,Teaching Hospital, Karapitiya, Sri Lanka, over the past ten years. The technique is simple, inexpensive and less time consuming. Aims of this study were to assess the level of improvement of maxillary unit length, facial appearance and quality of speech of patients following correction of mid facial hypoplasia using MMOD. Methods: Patients with midfacial hypoplasia (n:10, M: F –1:1, Age range : 14-22 yrs) surgically corrected with MMOD technique during 2013 were included. Increase of maxillary unit length, SNA & ANB angles and over-jet were assessed with study-models and cephalometric analysis pre-surgically and one year after surgery. The quality of speech was assessed using resonance, nasal air emission and consonant production error pre and post surgically. Results: All patients showed positive over-jet increase (mean: 4.3 mm) and improved anterior-posterior dimensions of maxilla (SNA mean increase: 8.5 ,ANB mean increase: 8.8 and average increase of Maxillary Unit Length/ANS - PNS: 6.2 mm). Findings were statistically significant (p Conclusions: MMOD is a less expensive, less invasive orthognathic surgical procedure where adequate distraction is possible with minimum relapse. Bone formation on either side of osteotomy cuts expand soft tissues as well, to improve facial aesthetics and reduce velo-pharyngeal insufficiency to improve speech.