New Internal Le Fort I Distractor for the Treatment of Midface Hypoplasia

A new Le Fort I internal distraction device was developed by one of the authors (J. G.) and successfully used on a patient with cleft lip and palate and severe maxillary hypoplasia. The device consisted of an upper plate and a lower plate, which were installed above and below the Le Fort I osteotomy. The upper plate was shaped like a "U," and the lower plate was shaped like an inverted "U." The design of the device was unique in that the distraction screws were placed in the maxillary sinus and orientated parallel to the sagittal plane. Presurgical planning used a stereolithographic (STL) model and the CASSOS software to calculate the distraction vector. The distractors were prebent and installed on the STL model and activated to advance the maxilla 15.5 mm. Surgery was performed in a conventional manner, and distraction was started on the seventh day after surgery. At the completion of distraction, a total of 15.5 mm of distraction was achieved. The distractors were removed 3 months after surgery. Results showed that the patient's severe maxillary hypoplasia was corrected as predicted and there was excellent new bone formation between the edges of the osteotomy.