Temporomandibular joint dislocation in patients with cleft lip and palate after maxillary distraction osteogenesis

摘要

Maxillary deficiency isacommon secondary deformity associated with cleft lip and palate(CLP). Aconsiderable number of patients withAngle class III malocclusion need orthognathicsurgery in eitheradolescence ofadulthood. Sincetherigid external distraction (RED) device was introduced for the management ofsevere midface hypoplasia by Polley and Figueroain 1997, [1]classic Le Fort I osteotomy followed bymaxillary distraction osteogenesis (DO) has beenwidely used for patients withCLP to advancetheir hypoplastic maxilla. This type oftechnology has been shown to sufficiently advancethe maxillaand reducerelapseregardless ofwhether the patient isan adolescent oradult. [2,3] Ourcenter has made some modifications to the REDdevice by using bone-borneintranasaltraction in order to avoid dentoalveolarcompensation during traction. [4] However, in ourclinical practice, weencountered three patients who experienced temporomandibular joint (TMJ) dislocation and limited mouth opening after maxillaryDO. To the best of our knowledge, there has been littleresearch on this topic. Here, we describethesethreecases.