Development of a new three-directional distractor system for the correction of maxillary transverse and sagittal deficiency

作者：Asan Canay Yilmaz^*; Kutuk Nukhet; Kurt Gokmen; Alkan Alper

来源：Journal of Cranio-Maxillofacial Surgery, 2018, 46(3): 424-431.

DOI：10.1016/j.jcms.2017.12.010

• Distraction
• Three-directional
• Distractor

Purpose: Class 3 malocclusions with maxillary deficiency, which are treated surgically and/or ordonotically, are common among adult patients. The aim of this study was to develop a three-directional bone-borne distractor that would allow the transverse expansion and sagittal advancement of the maxilla simultaneously.
Materials and methods: Computed tomography images of a patient with maxillary deficiency were transmitted to a software program, and a distractor was designed with different sizes (D1, D2, D3) and manufactured from titanium alloy. Y-shape segmental osteotomies were performed on the model, and vertical bite forces were applied. The biomechanical properties were evaluated by using the finite element method.
Results: The highest von Mises stress value on the body of the distractor was seen in D2 (D2>D3>D1), with 234 N bite forces. D2 had maximum stress distribution on maxillary bone under 234 N and 93 N (D2>D1>D3). No difference was found among the plastic deformation rates according to biomechanical test results.
Conclusion: A three-directional bone-borne palatal distractor was produced, and this distractor system can be used for the treatment of skeletal class 3 patients with maxillary hypoplasia for its advantages of shortening the overall treatment time and reducing the scar formation. However, further animal and clinical studies are essential to determine the biological response of soft and hard tissues.

• 出版日期2018-3