Maxillary growth after maxillary protraction: Appliance in conjunction with presurgical orthopedics, gingivoperiosteoplasty, and Furlow palatoplasty for complete bilateral cleft lip and palate patients with protruded premaxilla

Kobayashi, Shinji; Hirakawa, Takashi; Fukawa, Toshihiko; Maegawa, Jiro

doi:10.1016/j.bjps.2015.02.005

Cited by 9 publications

(6 citation statements)

References 20 publications

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“…Hence, the NAM has been used since then. 24 Regarding vertical relationship, the usage of PSOA has caused the SN-ANS maxillary downward trend with the centre of rotation near the posterior nasal spine for both age group. Maxillary rotation caused an increased in anterior midface height (N-ANS, SN-ANS).…”

Section: Discussionmentioning

confidence: 97%

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The Impact of Pre-surgical Orthopedics Appliances (PSOAs) in Bilateral Cleft Lip and Palate (BCLP) Patients

Shah

Makhtar

Yeap

et al. 2023

imjm

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INTRODUCTION: Acceptable maxillary growth in bilateral cleft lip and palate (BCLP) is difficult to achieve. Pre-surgical orthopedic treatment aims at the reduction of cleft size by guiding growth and functional rehabilitation. The objective of this study was to evaluate the impact of Pre-surgical Orthopedics Appliances (PSOAs) on facial growth in BCLP. MATERIALS AND METHODS: Consented subjects were patients who were treated in Hospital Universiti Sains, Malaysia, and Hospital Raja Perempuan Zainab II. Ages of patients ranged from 7 to 21 years of age with non-syndromic cleft and no associated anomalies. A lateral cephalogram was taken and data collected was analyzed to compare the facial growth of BCLP with and without PSOA and between active and passive PSOA. RESULTS: The study sample comprised of 52 BCLP patients with 26 having PSOA and 26 did not having PSOA. Among these patients, those who had PSOA had significant shorter length of PNS-ANS (3.69 mm; p= 0.04) and Co-A (8.38 mm; p=0.04) compared to those who did not have PSOA. However, there were no significant difference in the length measurements between passive and active PSOA users. CONCLUSION: The usage of PSOA gives a shorter maxillary length in the facial growth of bilateral cleft patients. This study proved the effectiveness of PSOA on facial growth of cleft patients in local population.

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Section: Discussionmentioning

confidence: 97%

“…It was also more superior for palatal expansion compared to NAM. 24 However, it could result in improper oral care and mucosal edema. Hence, the NAM has been used since then.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Pre-surgical Orthopedics Appliances (PSOAs) in Bilateral Cleft Lip and Palate (BCLP) Patients

Shah

Makhtar

Yeap

et al. 2023

imjm

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“…Nevertheless, we believe that GPP is of value in fixing the premaxilla through bone formation, and could decrease premaxillary retrusion if the premaxilla is not placed too far back (Kobayashi et al, 2015; 2017). We have actually found that occlusion tends to be relatively good after NAM, cheiloplasty, GPP, palatoplasty, and use of a maxillary protraction appliance without osteotomy when the protruded premaxilla is not placed too far back (Figure 4).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Congenital Maxillary Growth Using Computed Tomography in Patients With Bilateral Cleft Lip and Palate

Kobayashi

Yasumura

Hirakawa³

et al. 2019

The Cleft Palate-Craniofacial Journal

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Objective: To analyze congenital lateral maxillary growth for patients with bilateral cleft lip and palate (BCLP). Design: A retrospective study. Setting: Kanagawa Children’s Medical Center. Materials: Images from computed tomography (CT) of patients with BCLP and control patients that were previously used for treatment. Main Outcome Measures: The following landmarks were used: A, the posterior most point of the piriform aperture; B, the superior most point of the acoustic meatus; C, the point at which line A-B intersects the line drawn perpendicular from line A-B to the maxillary tuberosity; and D, the apical most point of the nasal bone. The following distances were then measured using these landmarks: (1) A-B distance; (2) A-C distance; (3) A-C/A-B; (4) the angle between lines A-B and A-D (∠BAD); and (5) B-D distance. Result: Mean A-B and A-C distances and A-C/A-B were significantly smaller in the BCLP group than in the control group ( P < .01 each). Mean ∠BAD was significantly larger in the BCLP group than in the control group ( P < .01). Mean B-D distance did not differ significantly between groups. Conclusions: Our results indicated that the lateral maxillary segments of patients with BCLP were more posterior than those of the control group, and segment length was shorter compared to the control group on 3D-CT analysis. The lateral maxillary segments of patients with BCLP were basically suggested to originally be underdeveloped.

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“…There can also be associated dental anomalies, including alterations in the number of teeth (64.2%), with dental agenesis having the highest incidence (44.3%), with the upper lateral incisor (33.8%) the most frequently associated on the side of the cleft (74%). Additional defects include supernumerary (19.8%), ectopic, or microdontic teeth [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18].…”

Section: More Informationmentioning

confidence: 99%

Premaxillary osteotomy in children with bilateral cleft lip and palate: Skeletal and dental changes

Gomez¹,

Camps²,

Baró³

2020

J Oral Health Craniofac Sci

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Purpose: To evaluate changes in children with bilateral cleft lip and palate (BCLP) who premaxillary osteotomy and secondary alveolar bone grafting as compared to children with BCLP who are not indicated for surgery, and to determine variables that diff erentiate patients who do or do not require osteotomy. Material and methods: Twenty-four children with BCLP were included in the study: 12 who underwent osteotomy (intervention group) and 12 who had no surgery (control group). Radiographic and model values of the intervention group were compared before (T1) and after (T2) premaxillary osteotomy, and measurements were compared with those from the control group at T1. Results: Convexity, ANB (point A-nasion-point B), and maxillary depth was more diminished at T2 in children in the intervention group. Point A, anterior nasal spine, and pogonion were retroposed after surgery, and the anterior spine was higher. At T2, the upper incisors were proinclinated and intruded, and overbite was improved. Models revealed increased intermolar intercanine width as well as intrusion of upper incisor after surgery. Premaxilla and upper molars were more extruded, had a higher total maxillary height and increased extrusion of upper incisor in children who underwent osteotomy. Conclusion: After surgery, children who undergo surgery have a premaxilla that is more normalized and more level with the occlusal plane, as well as improved dental inclination. Variables that diff erentiate children who require osteotomy from those who do not include more extrusion and protrusion of the premaxilla, and a greater extrusion of the upper incisors. Premaxillary osteotomy in children with bilateral cleft lip and palate: Skeletal and dental changes

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Maxillary growth after maxillary protraction: Appliance in conjunction with presurgical orthopedics, gingivoperiosteoplasty, and Furlow palatoplasty for complete bilateral cleft lip and palate patients with protruded premaxilla

Cited by 9 publications

References 20 publications

The Impact of Pre-surgical Orthopedics Appliances (PSOAs) in Bilateral Cleft Lip and Palate (BCLP) Patients

The Impact of Pre-surgical Orthopedics Appliances (PSOAs) in Bilateral Cleft Lip and Palate (BCLP) Patients

Evaluation of Congenital Maxillary Growth Using Computed Tomography in Patients With Bilateral Cleft Lip and Palate

Premaxillary osteotomy in children with bilateral cleft lip and palate: Skeletal and dental changes

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