الفهرس 
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Abstract
Cleft lip and palate patients with severe maxillary hypoplasia (in vertical, horizontal, and transverse dimensions) typically have a profile that is characterised by a small nasolabial angle, a short subnasal length, absent or abnormal dentition, and scarring of the palatal and pharyngeal soft tissues.
This The scar tissue in their upper lips and/or palates makes a significant advancement of the maxilla with traditional technique difficult, and this method is also linked to a high degree of recurrence in patients with severe cleft maxillary insufficiency, making it difficult to cure.
The primary objectives of this research are the development of a harmonious and balanced facial appearance and the restoration of normal occlusion.
Maxillary advancement with rigid external distraction (RED) was chosen as an effective tool for improving the facial profile of 12 patients (8 female and 7 male) by decreasing facial concavity, increasing nasal projection, normalising the nasolabial angle, advancing the upper lip, rebalancing lip posture, and exposing the upper incisor teeth more vertically. More than that The RED system offers benefits because to its capacity to modify the force vectors, allowing for vertical adjustment of the maxillary position through external hooks.
Virtual surgical planning (VSP) and computer assisted design (CAD) were employed in this research as cutting-edge tools for organising and carrying out CMF operations.
In order to accurately plan distraction procedures, we created virtual 3D models before surgery by collecting data from Multi-Slice CT in DICOM format, converting it to a 3D image, thresholding and segmenting it, and finally planning the site of the osteotomy on the maxilla (high lefort I osteotomy).
After a typical amount of time had passed, both cephalometric and clinical examinations showed consistent outcomes. It appeared that the RED device, used for distraction osteogenesis, reduced surgical risks and shortened the duration of the treatment.
Despite some minor drawbacks related to patient acceptance of the halo-frame and lack of compliance during the consolidation phase, an external device provided superior 3D control throughout the distraction process, suggesting that it is preferred in patients who would tolerate this therapy.
In conclusion, the RED system device can be regarded as a very powerful tool for management of post cleft hypoplastic maxilla due to its ability to address osseous and soft-tissue deficiencies in a single treatment regimen, despite its minimal complications, which can be managed by professional and experienced hand.
Virtual planning provides advantages in distraction osteogenesis due to its precision in diagnosing deformity, facilitating treatment optimization, and providing predictive value with regards to the mount and direction necessary for movement of the maxilla in both the horizontal and vertical axes.