EFFECT OF A TOOTH-BORNE INTER-DENTAL DISTRACTOR ON REDUCTION OF WIDTH OF ALVEOLAR CLEFTS

Abstract

Objective: The aim of this study was to evaluate the effect of a tooth-borne appliance for interdental distraction osteogenesis on the reduction of the width of wide alveolar clefts. Materials and methods: Seven patients were recruited to this study having wide alveolar clefts; wider than width of a canine (age from 12 to 25 years). The tooth borne distractor appliance was custom-made for each patient using micro-expansion screw, osteotomies were done under general anesthesia, then activation of the distractor was done until clinically there was complete closure of the alveolar cleft. After consolidation period, evaluation of cleft width reduction was examined radiographically. Statistical analysis was done, where all measurements were described in form of Mean and Standard Deviation. Comparison between pre-operative and post-operative data was done using paired t-test. Significance level was considered at P < 0.05. Results: Clinically there was a significant reduction of the width of the alveolar cleft as well as closure of the oro-nasal fistula was observed. Radiographically, width of the cleft was measured pre-distraction and post-consolidation at two levels; cervical level and apical level, In this study there was a statistically significant difference between width of the cleft before and after distraction (P-value= 0.011) at the caudal or occlusal part of the cleft, also there existed statistical difference in reduction of cleft width at the level of root apices (P-value=0.031), with a less mean of width post distraction, denoting tipping of teeth in the transport segment. Conclusion: This tooth-borne distractor was able to reduce the width of alveolar cleft but has a drawback of causing tipping of teeth in transport segment, which requires docking site surgery in order to close the cleft at the nasal side.