Orthognathic Surgery in Cleft Lip and Palate Patients

Abstract

Cleft lip and palate patients often exhibit severe dentofacial deformities that necessitate orthognathic surgery. Orthognathic surgery in these patients generally includes not only maxillary advancement, but also sagittal, horizontal, and vertical movement of both jaws. Surgical planning and execution presents many difficulties, caused by the presence of extensive scar tissues from previous surgeries, tissue deficiencies, the difficulty of aligning multiple segments of bone and soft tissues. Other challenges in cleft patients are complications related to post-surgical airway, speech, velopharyngeal insufficiency, nerve damage, and infections. This review is focused on orthognathic surgery in cleft lip and palate patients, management, techniques, success, and complications.

Orthognathic Surgery's Effects on Subjects with Cleft Lips' Speech and Breathing

“…The total airway amount in each cluster was long-drawn-out from prepubertal to post-pubertal intervals, but the cause for this concluding results withinside the branched association crooked into nowadays no elongated anteroposterior increase as withinside the case of the complete association, but in discrepancy, associated with perpendicular airway surge. Specifically in two-pronged cleft fatalities, significantly diminished guttural consonant airway echoing planetary in estimation to persons with out clefts twisted into as well showed in a CBCT learning [3].…”

Orthognathic Surgery's Effects on Subjects with Cleft Lips' Speech and Breathing

“…The total airway amount in each cluster was long-drawn-out from prepubertal to post-pubertal intervals, but the cause for this concluding results withinside the branched association crooked into nowadays no elongated anteroposterior increase as withinside the case of the complete association, but in discrepancy, associated with perpendicular airway surge. Specifically in two-pronged cleft fatalities, significantly diminished guttural consonant airway echoing planetary in estimation to persons with out clefts twisted into as well showed in a CBCT learning [3].…”

Current Treatment of Cleft Lip and Palate

“…Although most studies focused on horizontal maxillary stability, Park et al [63] reported that postoperative mandibular relapse in cleft patients had a strong positive correlation with mandibular clockwise rotation and setback amounts. Wong et al [64] could not find a significant difference between the relapse rates of individuals who received two surgical operations and those who received maxillary advancement surgery only. Some researchers used bone grafts to increase horizontal or vertical stability [61,63,64].…”

“…Wong et al [64] could not find a significant difference between the relapse rates of individuals who received two surgical operations and those who received maxillary advancement surgery only. Some researchers used bone grafts to increase horizontal or vertical stability [61,63,64]. It was reported that usage of grafts has a preventive effect on horizontal maxillary stability with an average of 1.72 mm less relapse [61].…”

Novel Difficulty Index for Cleft Maxillary Orthognathic Surgery

“…Several attempts to repair the esthetics of the lips results in even greater tightness. [15,16,30] This necessitates the use of an Abbe flap, as a separate surgical procedure in some of these cases, before undergoing the orthognathic surgical procedure. [34,35] Therefore, it is believed that this creates a greater burden on the patient during the preparation for the orthognathic surgery.…”

Orthognathic Surgery's Effects on Subjects with Cleft Lips' Speech and Breathing

“…The total airway amount in each cluster was long-drawn-out from prepubertal to post-pubertal intervals, but the cause for this concluding results withinside the branched association crooked into nowadays no elongated anteroposterior increase as withinside the case of the complete association, but in discrepancy, associated with perpendicular airway surge. Specifically in two-pronged cleft fatalities, significantly diminished guttural consonant airway echoing planetary in estimation to persons with out clefts twisted into as well showed in a CBCT learning [3].…”

Current Treatment of Cleft Lip and Palate

“…Although most studies focused on horizontal maxillary stability, Park et al [63] reported that postoperative mandibular relapse in cleft patients had a strong positive correlation with mandibular clockwise rotation and setback amounts. Wong et al [64] could not find a significant difference between the relapse rates of individuals who received two surgical operations and those who received maxillary advancement surgery only. Some researchers used bone grafts to increase horizontal or vertical stability [61,63,64].…”

“…Wong et al [64] could not find a significant difference between the relapse rates of individuals who received two surgical operations and those who received maxillary advancement surgery only. Some researchers used bone grafts to increase horizontal or vertical stability [61,63,64]. It was reported that usage of grafts has a preventive effect on horizontal maxillary stability with an average of 1.72 mm less relapse [61].…”

Novel Difficulty Index for Cleft Maxillary Orthognathic Surgery

“…Several attempts to repair the esthetics of the lips results in even greater tightness. [15,16,30] This necessitates the use of an Abbe flap, as a separate surgical procedure in some of these cases, before undergoing the orthognathic surgical procedure. [34,35] Therefore, it is believed that this creates a greater burden on the patient during the preparation for the orthognathic surgery.…”

Orthognathic Surgery's Effects on Subjects with Cleft Lips' Speech and Breathing

“…The total airway amount in each cluster was long-drawn-out from prepubertal to post-pubertal intervals, but the cause for this concluding results withinside the branched association crooked into nowadays no elongated anteroposterior increase as withinside the case of the complete association, but in discrepancy, associated with perpendicular airway surge. Specifically in two-pronged cleft fatalities, significantly diminished guttural consonant airway echoing planetary in estimation to persons with out clefts twisted into as well showed in a CBCT learning [3].…”

Current Treatment of Cleft Lip and Palate

“…Although most studies focused on horizontal maxillary stability, Park et al [63] reported that postoperative mandibular relapse in cleft patients had a strong positive correlation with mandibular clockwise rotation and setback amounts. Wong et al [64] could not find a significant difference between the relapse rates of individuals who received two surgical operations and those who received maxillary advancement surgery only. Some researchers used bone grafts to increase horizontal or vertical stability [61,63,64].…”

“…Wong et al [64] could not find a significant difference between the relapse rates of individuals who received two surgical operations and those who received maxillary advancement surgery only. Some researchers used bone grafts to increase horizontal or vertical stability [61,63,64]. It was reported that usage of grafts has a preventive effect on horizontal maxillary stability with an average of 1.72 mm less relapse [61].…”

Novel Difficulty Index for Cleft Maxillary Orthognathic Surgery

“…Several attempts to repair the esthetics of the lips results in even greater tightness. [15,16,30] This necessitates the use of an Abbe flap, as a separate surgical procedure in some of these cases, before undergoing the orthognathic surgical procedure. [34,35] Therefore, it is believed that this creates a greater burden on the patient during the preparation for the orthognathic surgery.…”