© 1988 by European Orthodontic Society
Protraction of the cleft maxilla
Helsinki Finland
1Dr Reijo Ranta Cleft Center, I Department of Surgery, Helsinki University Central Hospital Pohjoinen Hesperiankatu 17 SF-00260 Helsinki Finland
The effect of forward maxillary protraction with the Delaire type of face mask was studied in fourteen patients with cleft lip and palate. Primary surgical treatment included various methods of lip surgery at the age of 2–4 months and palatal closure by push-back at the age of 18–24 months. Traction on the maxilla was initiated between 9 and 15 years of age and its duration ranged from 5 to 28 months, averaging 15 months. The average magnitude of the traction forces was 300–400gm. Parallel or downward directed forces in relation to the occlusal plane, were used from the first molars and the pre-canine loops of the archwire. Forward translation of the maxilla was observed in five, 9–11-year-old patients. No movement of this type was observed in four, 10–11-year-olds and in five patients over 12 years of age. The reason for the poor results may be lack of cooperation; or the small magnitude of the forces; or the effects of surgery which may have prevented forward movement of the maxilla. Unfavourable rotation of the maxilla could be controlled by modified directions and points of application of the forces. A slight retrusion of the mandible was observed in nine patients and was independent of age. In spite of the poor results of forward translation of the maxilla in the older patients, face mask therapy proved to be successful in correction of the anterior crossbite and spacing of the dental arch, and as an anchor in widening the upper dental arch.