Design of an internal distraction device for maxillary advancement in cleft-lip-palate patients

Abstract

Introduction: Cleft lip and palate (CLP) is the most frequent craniofacial defect. (1:1000 newborns). CLP patients present severe maxillary retrusion that require a surgical procedure to advance their maxilla. Distraction osteogenesis is an effective treatment; however available internal maxillary distraction devices present inconveniences. Objective: To design a biocompatible, inexpensive and mechanically efficient prototype of an internal maxillary distraction device. This device should be easy to place and comfortable for the patient. Method: Computed tomography (CT) data of an adult CLP patient was obtained. DICOM files were processed and a stereolitographic (STL) model was printed. Computer aided design (CAD) software was used to design the device and to perform a fi nite element analysis (FEA) to evaluate the mechanical behavior of the appliance. Finally a prototype was manufactured by a computer aided manufacturing (CAM) process and tested on the STL model. Results: This prototype complied with our requirements for an effi cient internal maxillary distraction device. Conclusions: The integration of clinical knowledge with novel technology (CT, STL, CAD, FEA, and CAM) is very useful for the development of medical or dental appliances.Key words: Distraction osteogenesis, fi nite element analysis, cleft lip and palate.