Page 155 - Read Online
P. 155
Fariña et al. Skeletal anchorage for rigid external distractor
means that the line of action of the force vector is direct Financial support and sponsorship
as there is no intermediary device to reduce the force. None.
[5]
As Figueroa and Polley discuss, the wire splint of
RED I, which has an extraoral wire and traction hooks, Conflicts of interest
has some flexibility, which allows the distraction wire
force to accumulate and then be liberated gradually. In The authors have no commercial or financial
associations that might create a conflict of interest with
other words, once the screw is activated, the distraction the information presented in this manuscript.
effect is not immediate, but as the wire recovers its
shape it becomes a continuous tension. [3,11,19] We Patient consent
believe the mechanism described by the authors is
[5]
not ideal because the wire undergoes elastic deformity All patients signed an informed consent letter before
that prevents the applied force from being transferred participating in the study.
in its entirety to the bone being distracted. [11,12]
Ethics approval
SARED is more comfortable than the intraoral splint This study was approved by ethical board of Hospital
anchorage, because it does not interfere with the del Salvador.
functions of the oral cavity. It allows uninterrupted
eating because there is no device, wires or splints REFERENCES
inside the mouth. Patients can, therefore, brush their
teeth even when they have braces. In addition, patients 1. Polley JW, Figueroa AA. Rigid external distraction: its application in
with SARED can continue their orthodontic treatment cleft maxillary deformities. Plast Reconstr Surg 1998;102:1360-72;
during the whole distraction and consolidation period. discussion 1373-4.
2. Polley JW, Figueroa AA. Management of severe maxillary deficiency
in childhood and adolescence through distraction osteogenesis with
The percutaneous exits of the wires from the nasolabial an external, adjustable, rigid distraction device. J Craniofac Surg
folds do not compromise aesthetics because the 1997;8:181-5; discussion 186.
scars are hidden in face wrinkles. Other authors have 3. Molina F, Monasterio FO, de la Paz Aguilar M, Barrera J. Maxillary
previously suggested the use of percutaneous wires distraction: aesthetic and functional benefits in cleft lip-palate and
emerging from the zygomatic bone to distract with prognathic patients during mixed dentition. Plast Reconstr Surg
1998;101:951-63.
RED II and have reported no major complications. [18] 4. Combs PD, Harshbarger RJ 3rd. Le fort I maxillary advancement
using distraction osteogenesis. Semin Plast Surg 2014;28:193-8.
Finally, SARED does not require further surgery to be 5. Figueroa AA, Polley JW. Management of severe cleft maxillary
removed, as do osteosynthesis anchored devices. [11] deficiency with distraction osteogenesis: procedure and results. Am J
The halo and wires can be pulled out without local Orthod Dentofacial Orthop 1999;115:1-12.
anaesthetic on an outpatient basis. The use of SARED 6. Burstein F, Soldanska M, Granger M, Berhane C, Schoemann M.
Initial experience with a new intraoral midface distraction device. J
simplifies a process that is highly complex itself and Craniofac Surg 2015;26:1224-8.
delivers better conditions for the patient and surgeon. 7. Nishimoto S, Oyama T, Shimizu F, Tsugawa T, Nagashima T,
Yamamoto K, Kamiji T, Kanomi R. Fronto-facial monobloc
Using SARED is a convenient method to distract the advancement with rigid external distraction (RED-II) system. J
midface. Advantages include better control of the Craniofac Surg 2004;15:54-9.
distraction vector and force when compared to the use 8. Miyazaki H, Katada H, Ichinokawa Y, Hirabayashi S, Sueishi K.
Orthodontic treatment in combination with Le Fort II bone distraction
of a dental anchorage (RED I) or a dental anchorage in patient with Apert syndrome. Bull Tokyo Dent Coll 2013;54:9-17.
with an osteosynthesis plate anchorage (RED II). 9. Raposo-Amaral CE, Denadai R, Ghizoni E, Buzzo CL, Raposo-
SARED improves patient comfort levels, oral hygiene Amaral CA. Family of crouzon syndrome represents the evolution of
and overall oral health. The method proposed is simple, the frontofacial monobloc advancement technique: from immediate
reduces costs and complications. movement to monobloc distraction to monobloc bipartition distraction.
J Craniofac Surg 2015;26:1940-3.
10. Nout E, Cesteleyn LL, van der Wal KG, van Adrichem LN, Mathijssen
DECLARATIONS IM, Wolvius EB. Advancement of the midface, from conventional Le
Fort III osteotomy to Le Fort III distraction: review of the literature.
Authors’ contributions Int J Oral Maxillofac Surg 2008;37:781-9.
Concept, design, definition of intellectual content, 11. Baek SH, Seo YJ. Application of orthodontic mini-implants and
literature search, clinical studies, data acquisition, data ligation for absolute skeletal anchorage to the intraoral labiolingual
appliance: midface distraction osteogenesis cases treated with the
analysis, statistical analysis, manuscript preparation, RED System. J Craniofac Surg 2011;22:609-13.
manuscript editing, and manuscript review: R. Fariña, 12. Resnick CM, Rottgers SA, Langenfeld CC, Mulliken JB, Padwa
F. Salinas BL. Novel rigid external distraction device improves stability and
148 Plastic and Aesthetic Research ¦ Volume 4 ¦ September 05, 2017