Distraction osteogenesis in treatment of unilateral alveolar cleft

Abstract

Objective This study was planned to compare the distraction of the lesser segment versus the greater segment via usage of (Liou cleft distractor) in repair of unilateral alveolar cleft. Patients & Methods 16 patients with unilateral alveolar clefts were included in this study. They were divided into two equal groups according to the osteotomized segment, Group I: in which the lesser bone segment was osteotomized for alveolar cleft repair. Group II: in which the greater segment was osteotomized for alveolar cleft repair. Results Stage I distraction: after three months, showed significant difference in the width of the cleft side in both groups as P-value was 0.007 in group I and P-value was 0.001 in group II. No significant differences in the vitality and mobility of teeth in both groups. The amount of relapse in the regenerate area at the different observation periods 3 and 6 months between both groups were statistically significant (P-value 0.018). Radiographic finding showed no significant difference of the inclination changes of the transported segment in group I (P-value 0.816), while in group II showed significant difference (P-value 0.001). Stage II alveolar cleft grafting: graft resorption and recurrence of fistula was recorded in one case of group II. The differences of the density of the grafted bone between the first month and six months in each group postoperatively were statistically significant in both groups as P-value 0.001 and 0.001 in group I and Group II respectively. Conclusion Both the lesser and the greater segments are suitable for treatment of alveolar cleft with some drawbacks related to the palatal inclination of transported segment in group II as compared to group I.