Devices available for
left and right alveolar
clefts 15mm and 20mm.
Bilateral or unilateral wide alveolar cleft or
oronasal fistula in bilateral cleft lip and
Maxillary alveolar bony defect due to trauma.
Creating interdental edentulous space for
maxillary dental crowding.
Maxillary lengthening for maxillary hypoplasia
with or without dental crowding, and with or
without alveolar cleft.
Developed in cooperation with Dr. Eric Liou
Chang Gung Memorial Hospital, Taipei, Taiwan
1. The lateral segments in bilateral cleft or lesser segment in unilateral cleft is usually the dental arch to be distracted.
However, it varies regarding different clinical situations of the cleft or defect. The site of interdental osteotomy is at
which the interdental osteotomy can be performed without damaging the dental roots. During osteotomy, care must be
taken to preserve 0.5-1 mm thickness of interdental alveolar bone adjacent to the dental roots. The widest interdental
alveolar bone usually is between the maxillary 1st molar and 2nd premolar. However, it varies regarding different clinical
situations of tooth alignment.
2. A horizontal intraoral incision is made along the buccal vestibule of the maxilla. Superior based mucoperiosteal
flaps are reflected, exposing the site of horizontal maxillary osteotomy on the buccal side. A vertical mucoperiosteal tunnel
extending upward from the interdental attached gingiva to the horizontal incision is made to expose the site of vertical
interdental osteotomy. Another small incision, on the palatal side, is made inside the gingival sulcus, exposing the
site of interdental osteotomy. Care must be taken to avoid reflecting or stripping all of the palatal mucosa.
3. By estimating on the radiographs or stereolithographic model, the anatomic position of the dental roots, sites of
interdental and horizontal maxillary osteotomies, and permanent tooth buds are marked on the alveolar bone with surgical
4. Complete horizontal osteotomy is performed with a cutting saw, 3 to 5 mm away from the dental root apex and
tooth buds. Complete interdental osteotomy is then performed with a small round bur and followed by a thin osteotome,
cutting through the buccal and palatal cortical plates respectively. As the cutting round bur encounters the cancellous
bone, the thin osteotome is then used for cutting carefully through the interdental cancellous bone buccolingually.
Before completing the interdental osteotomy, the distraction device is mounted on the proximal and distal segments
across the interdental osteotomy line. After the fixation of the device with bone screws, the interdental osteotomy is then
completed by the thin osteotome. Before closure of the wound, the device is tested by turning the screw forward completely
and then backward completely.
5. The incisions were irrigated and closed with absorbable suture.
6. Distraction protocol: A latency period of 5 days (younger patients) to 7 days (adult patients) is observed before
initiation of distraction osteogenesis. The distraction device is activated every day until both ends of the alveolar cleft or
oronasal fistula has been approximated. Rhythmic distraction is carried out at the rate of 0.9 mm/day (3 turns/day).
During interdental distraction, the distracted segment is allowed to move along the orthodontic arch wire in a curvalinear
direction. After completion of interdental distraction, the device was left in place for another 2 to 3 months before
7. Post-distraction orthodontic tooth movement: the orthodontic tooth movement into the distracted regenerate
(rapid orthodontic tooth movement) is initiated 2 to 3 weeks after completion of the distraction.
51-650-15 Liou Cleft Transport Distractor 15mm, Left
51-651-15 Liou Cleft Transport Distractor 15mm, Right
51-650-20 Liou Cleft Transport Distractor 20mm, Left
51-651-20 Liou Cleft Transport Distractor 20mm, Right
KLS-Martin L.P. P.O. Box 50249 • Jacksonville, FL 32250-0249
Phone 904-641-7746 • Toll Free 1-800-625-1557
Fax 904-641-7378 • www.klsmartin.com
Distributed outside U.S.A. and Canada
P.O. Box 60 • D-78501 Tuttlingen - Germany
Telephone (0 74 61) 7 06 - 0 • Telefax (0 74 61) 7 06 193