Comparing Surgical Advancement Outcomes of Retruded Maxilla in a Group of Egyptian Cleft Lip and Palate Subjects

Abstract

BACKGROUND: Cleft lip and palate (CLP) is one of the most common congenital deformities involving intervention in several sub-specialties. AIM: The present study was conducted to investigate the amount of maxillary advancement obtained by three different methods. METHODS: A retrospective comparative study was conducted on 24 CLP patients who were treated with three surgical maxillary advancement techniques: Group A was treated with Le Fort I (LFI) orthognathic surgery with bone grafting and rigid fixation (LFI). Group B was treated with intraoral maxillary bone distraction (MIDO). Group C was treated with orthodontic traction by facemask (orthodontic facemasks [OFM]) plus corticotomy. All pre-operative data were collected, which included intraoral and extraoral clinical photos and dental casts. Pre-operative radiographic assessment was compared with post-operative values using digital panorama, multi-slice computed tomography and lateral cephalometric X-ray measuring Sella-nasion-A point; point A-nasion-point B points, with a follow-up period of 6 months. RESULTS: All approaches showed statistically significant success in maxillary advancement with p < 0.01. LFI has produced the highest advancement obtained with regard to the pre-operative advancement required (8.6 ± 1.4) and post-operative advancement achieved (7.8 ± 0.8). MIDO technique is an alternative method to LFI, but it gives less achieved post-operative maxillary advancement (6.25 ± 0.8) and is indicated for moderate cases. OFM gave the least advancement results; however, it has been the most convenient less-invasive method and was more suitable for unsevere cases. CONCLUSIONS: The three approaches produced satisfactory results in rehabilitating deficient maxilla in cleft patients, although each technique has limitations and indications. Future research is recommended to assess the technique’s long-term stability.

Soft-Tissue Changes in Unilateral Cleft Lip and Palate Patients after Non-surgical Maxillary Advancement with Face Mask Therapy - A Prospective Cohort Study

“…Patients with cleft lip and palate who may have a retruded maxilla may have psychological and functional issues as a result of their appearance. [ 24 ] The participants in this study were 20 pubertal patients who underwent non-surgical maxillary advancement using an orthopaedic face mask with elastic traction. The results of this study demonstrated that when the face mask approach was used, both upper and lower lip soft-tissue points improved significantly, while nasal soft-tissue points remained unaltered, necessitating more management in the future.…”

Three-dimensional evaluation of maxillary sinus volume following the use of different designs of rapid maxillary expander

“…A substantial proportion of patients suffer from posterior cross-bite associated with significant maxillary deficiency, high arched palate, and airway constriction. This could present in mild to severe forms according to the associated skeletal growth abnormalities, or congenital clefts [1][2][3].…”

Hyaluronic filler for lip augmentation and scar correction in cleft lip Egyptian patients

“…[4,5] Absence of volume is mainly caused by soft tissue deficiency, insufficient planning and inability to reconstruct the lower part of the Orbicularis Oris muscle during the initial lip repair. [6][7][8] If more bulk is needed, relatively small filler grafts can be used. Subcutaneous tissue flaps and autologous fascial, fat graft or dermal fillers are also used.…”