Alveolar Distraction Osteogenesis: ArchWise Appliance and Technique

132 Pages·2015·16.35 MB·English

by  Nejat Erverdi

Nejat Erverdi
Melih Motro
Alveolar Distraction
Osteogenesis
ArchWise Appliance
and Technique
123
Alveolar Distraction Osteogenesis

Nejat Erverdi (cid:129) Melih Motro
Alveolar Distraction
Osteogenesis
ArchWise Appliance and Technique
Nejat Erverdi Melih Motro
Faculty of Dentistry Henry M. Goldman School of
Department of Orthodontics Dental Medicine
University of Marmara Department of Orthodontics &
Istanbul Dentofacial Orthopedics
Turkey Boston University
Boston, Massachusetts
ISBN 978-3-319-07706-2 ISBN 978-3-319-07707-9 (eBook)
DOI 10.1007/978-3-319-07707-9
Springer Heidelberg Dordrecht London New York
Library of Congress Control Number: 2014950890
© Springer International Publishing Switzerland 2015
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To my wife Haviye and my children Zeynep, Ozan and Duygu
Nejat Erverdi
I dedicate this book to my great family: Pelin, my wife and my
best friend; my parents and my sister
Melih Motro

Pref ace
Cleft lip and palate is a serious problem with a prevalence of 1–7 in every
1,000 births. Gathering of a dedicated team which involves a plastic surgeon,
orthodontist, pedodontist, prosthodontist and speech therapist is very impor-
tant for successful treatment of these patients.
One of the major roles is played by the orthodontist throughout the
patient’s life from birth to adulthood. The role starts usually in the fi rst days
after the baby opens his/her eyes. Orthodontists apply nasoalveolar molding
for orthopaedic correction of alveolar segments to create a base for successful
palatal surgeries. In Marmara University we have been using this protocol for
a decade now. Unfortunately we cannot reach all the patients in these early
stages. Most of the patients come to orthodontists at adolescence, which force
us to plan more radical treatments for good treatment results. These patients
usually show maxillary defi ciencies sagitally, vertically and transversally,
and most of the patients are still having fi stula after primary surgeries.
In these cases, secondary surgeries cover a major part of the treatment.
Orthognathic surgery is suggested in many cases to solve such problem.
However, possibility of increasing the velopharyngeal insuffi ciency, which is
present in most of the cases, can create additional speech problems.
Another problem which arises in the treatment of cleft palate patients is
seen as a result of primary surgeries which are used for the closure of huge
alveolar and palatinal defects. Success in bone grafting to close the defects is
limited because of lack of enough gingival tissue to cover the graft area. In
general approach, tongue or buccal mucosal fl aps are used to repair the area.
Both tissues are not suitable to replace healthy gingival tissue and fail in
covering the expectations for a successful treatment.
D istraction osteogenesis can be a successful alternative to treat the cases
without creating the problems listed above. In the recent years, alveolar dis-
traction osteogenesis was used by constructing custom fabricated appliances,
and some successful case reports were presented. We started to use this pro-
tocol almost 10 years ago. At the beginning, we were using linear distraction,
but today we came to a level in which archwise distraction is used for the
treatment of cleft palate problem. In this book, along with the basics of dis-
traction osteogenesis, we will share our experience beginning with our previ-
ous methods and appliances. Improvement of our method until we reached
archwise distraction will be explained step by step. We hope and believe that
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viii Preface
this book will be extremely useful to colleagues and students who want to
have a different point of view in cleft lip and palate treatment of adolescent
patients.
Istanbul, Turkey Nejat Erverdi
Boston, Massachusetts Melih Motro
Acknowledgements
T he authors would like to thank all the professors and residents of the
Marmara University. Especially Dr. Buket Coskuner Gonul, Dr. Berza
Yilmaz, Dr. Kadir Beycan, and Dr. Burcu Usta Selamet for spending a lot of
effort in treating patients with us. Professors Dr. Nazankucukkeles, Dr. Sibel
Biren, Dr. Ahu Acar, Dr. Banu Cakirer Bakkalbasi, Dr. Mustafa Ates, Dr.
Sirin Nevzatoglu, and Dr. Nuray Yilmaz for sharing their valuable experience
with us. Dr. Kemal Ugurlu and Dr. Mesut Sarac for performing all the surger-
ies. Dr. Rifat Gozneli for making the fi nal restorations of the patient, and Dr.
Ali Murat Kokat for his wonderful illustrations and prosthetic restorations.
To Tasarimmed Company for producing our distractor designs, and fi nally to
our patients that deserve the best treatment that we can provide.
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