Distracción maxilar con máscara de Delaire en pacientes fisurados labio palatinos en dentición mixta

Résumé

In palatal clef patiens, the development of deformities is more frequent in the general population, this is due to the malformation itself and the iatrogenic consequence of previous interventions. The most frecuent alteration is a maxilary hipoplasia that appears after the closing of the cleft. This patients have a class III, with a concave facial morphology by multidimensional maxillary hipoplasia, deficient in the sagital, vertical and transverse plane. Aim: to get advance of the maxilla by Lefort I corticotomy and Delaire mask. Material and methods: three cleft patients with maxillary retrusion and mixed dentition were trated. They undergone Le fort I corticotomy and orthopedic treatment with a buccal-palatal arch with Nance appliance and Delaire facial mask. Results: the lateral X-ray post-distraction showed in all cases maxillary advancement, there were also changes in the molar and canine relationship. Bone was formed in the pterygomaxillary fissure and in the step of the Le Fort I osteotomy. The aesthetic and funcional result obtained are excelent, facial proportions being restored. Conclusion: in the cleft patients with severe maxillary hipoplasia and mixed dentition, the treatment of choice is the maxillary corticotomy and bring foward with Delaire mask to obtain the desired preogress and improvement of the facial profile. The result remains satable over time.