Abstract.

The RED system is one of the most effective midface distractors in maxillary deficiency of cleft patients. However, determining the correct vector and accurately transferring it to the patient is incompetent and time consuming. We designed a new guiding stent that allowed the precise replication of the virtual pre-planned vector prior to commencing the general anaesthesia. Thus, improving the outcome, facilitating the procedure and dramatically reducing the operative time. The purpose of this study was determining the best vector via virtual surgery, virtually mounting the haloframe of the red system and the oral device in place,accurately mimicking the preplanned red haloframe and oral device to the actual patient position via the guiding stent,and to facilitate preanesthetic mounting,disassembly to allow osteotomies then reassembly again in the same position. One patient with midface hypoplasia due to cleft lip and palate underwent maxillary distraction osteogenesis using a rigid external distraction device in combination with the proposed removable stent that was fixed onto the maxillary teeth and the face to provide accurate vectorial guidance to the proposed advancement. Initial records showed severe maxillary hypoplasia and negative overjet. No complications inserting or removing the splint post-surgically, including pain or discomfort, were observed. The use of the removable stent has proved to be a highly effective guiding tool to manage the severely hypoplastic maxilla, eliminating unwanted advancement ,reducing operative time and obtaining more accurate results