Mid-facial distraction with an intra-oral trans-sinusoidal distractor

Nine patients age 8 to 39 years with severe maxillary and midfacial hypoplasia were treated in our centre. Two trans-sinusoidal maxillary distractors (TS-MD, developed by Dr. N. Nadjmi in cooperation with KLS Martin,Tuttlingen, Germany) were placed intra-oraly at each side of the maxilla. The distraction vector was predicted using a special software, and was transferred to the patients using stereolithographic models and individual templates. A high LF I type osteotomy was performed. Forward maxillary movement at distractor level varied from 7 to 17.5 mm (mean, 12.9 mm). Soft and hard tissue formation resulted in complete heating across the distraction gaps. The maxillary movements and new bone formation in the sagital, horizontal, and vertical planes could be predicted and achieved. The distractors are almost completely submerged, and can be left in place as long as necessary to avoid relapse.