Long-term stability of LeFort III distraction osteogenesis with a rigid external distraction device in a patient with Crouzon syndrome.

Abstract

A 6-year-old boy, diagnosed with Crouzon syndrome, had moderate exorbitism, a concave profile, an anterior crossbite of -4.0 mm, and a skeletal Class III jaw-base relationship caused by midfacial hypoplasia. At age 8 years 9 months, a LeFort III osteotomy was performed, and distraction osteogenesis was immediately started with the rigid external distractor system. The midface was advanced approximately 10.0 mm for 6 days, including overcorrection. After the distraction, a reverse headgear was used for 6 years to prevent relapse and to accelerate expected growth. At age 16 years 5 months, after extraction of the maxillary first premolars and mandibular third molars, 0.022-in preadjusted edgewise brackets were placed to treat the edge-to-edge incisor relationship and minor crowding. After 13 months of treatment, the facial profile was significantly improved, and an acceptable occlusion was achieved. During the 9-year observation period after the distraction, acceptable facial growth occurred, and no relapse of the maxillary advancement was observed. However, syndrome-specific growth and methodologically induced relapse should be considered when planning a LeFort III distraction in children for the treatment of Crouzon syndrome.

• Authors: Shingo Kuroda, Keiichiro Watanabe, Kyoko Ishimoto, Hideki Nakanishi, Keiji Moriyama, Eiji Tanaka
• Journal: American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics (Am J Orthod Dentofacial Orthop) Vol. 140 Issue 4 Pg. 550-61 (Oct 2011) ISSN: 1097-6752 [Electronic] United States
• PMID: 21967944 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2011 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Topics

• Bicuspid (surgery)
• Cephalometry (methods)
• Child
• Craniofacial Dysostosis (surgery)
• External Fixators
• Extraoral Traction Appliances
• Follow-Up Studies
• Humans
• Male
• Malocclusion, Angle Class III (surgery, therapy)
• Maxilla (surgery)
• Maxillofacial Development (physiology)
• Molar, Third (surgery)
• Orthodontic Brackets
• Osteogenesis, Distraction (instrumentation, methods)
• Osteotomy, Le Fort (methods)
• Palatal Expansion Technique (instrumentation)
• Patient Care Planning
• Serial Extraction
• Tooth Movement Techniques (instrumentation)
• Treatment Outcome