Soft Tissue Changes in Cleft Lip and Palate Patients: Anterior Maxillary Distraction versus Conventional Le-Fort I Osteotomy

Markose, Eldho; Paulose, Joby; Paul, Eldho T.

doi:10.1007/s12663-012-0467-2

Cited by 17 publications

(9 citation statements)

References 28 publications

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“…Presently distraction osteogenesis (AMD) has become a mainstream surgical technique in treatment of jaw deficiencies [10]. Published cephalometric post treatment results in series of case reports and research papers have proved AMD to produce better results than conventional Le Fort I surgery [1,[28][29][30][31][32][33][34]. In the present study routine frontal and profile photographs were analysed to compare the soft tissue changes in both ALO and AMD.…”

Section: Discussionmentioning

confidence: 99%

“…This is in continuation of our study on soft tissue changes in cleft lip and palate patients treated by anterior maxillary distraction (AMD) and conventional Le Fort I osteotomy (ALO) in which cephalometric soft and hard tissue analysis was employed [1].This is an attempt to re-evaluate the soft tissue changes using frontal and profile photographs.…”

Section: Introductionmentioning

confidence: 89%

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Photometric Evaluation of Soft Tissue Changes in CLP Patients: Le Fort I Advancement Osteotomy (ALO) Versus Anterior Maxillary Distraction (AMD)

Paulose

Markose

2013

J. Maxillofac. Oral Surg.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 89%

Photometric Evaluation of Soft Tissue Changes in CLP Patients: Le Fort I Advancement Osteotomy (ALO) Versus Anterior Maxillary Distraction (AMD)

Paulose

Markose

2013

J. Maxillofac. Oral Surg.

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“…Orthognathic surgery is a treatment option for adult patients. It improves the skeleton and facial profile (11)(12)(13)(14)(15). Early orthodontic treatment in growing subjects mainly relies on orthopedic mechanics with fixed appliance and protraction headgear (16)(17)(18)(19), class III traction via miniplate and screws (20).…”

Section: Introductionmentioning

confidence: 99%

Soft Tissue Profile Changes Following Orthodontic Treatment in Patients With Unilateral Cleft Lip and Palate

2018

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Background: Anterior crossbite is a frequent malocclusion in patients with Unilateral Cleft Lip and Palate (UCLP). Several studies have investigated the effects of orthognathic surgery or orthopedic treatment on correction of this malocclusion. Only few studies evaluated the effect of conventional orthodontic treatment on growing patients Objective: The present study investigated significant changes of facial profile as well as the underlying hard tissue following conventional orthodontic treatment in growing subjects with UCLP. Methods: Lateral cephalograms of 32 non-syndromic children with UCLP (15 boys, 17 girls) with the Mean±SD age of 10.91±2.00 years were retrospectively collected. All patients had complete orthodontic records before and after treatments, indicating the acceptable treatment results, in respect of the degree of overbite, overjet, maximum intercuspation occlusion and facial profile. Cephalometric measurements represented dentoskeletal and soft tissue profile before and after treatments were evaluated, and significant changes were assessed by paired t test. Onesample t test was used to analyze significant differences between these measurements and the clinical norm. Results: The initial characteristics of the UCLP patients were skeletal class III maxillary retrusion with relative mandibular prognathism, retroclination of the incisors, negative overjet, and increased overbite and concave facial profile. After conventional orthodontic treatment, maxillary arch expansion and class III elastic traction, the acceptable overbite and overjet were achieved by proclination of the upper incisors. Significant changes of the soft tissue profile due to facial growth and treatment included increase in facial convexity, nose length, nose depth, columellar length, soft tissue face height ratio, upper and lower lip lengths and upper lip protrusion. The soft tissue profile was acceptable after the treatment, compared to the clinical norm. Conclusions: The early correction of the anterior crossbite with maxillary arch expansion and class III traction could improve the soft tissue facial profile of patients with UCLP.

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“…Although Le Fort I maxillary advancement improves both Class III malocclusion and facial disharmony, [1][2][3][4] it also causes well-known soft tissue changes to the nose and lip, including nasal tip elevation, shortening of the nose, alar base widening and flattening, and upper lip thinning and lengthening. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] Previous reports have examined the effect of maxillary advancement on nasolabial configuration, predominantly in patients without cleft lip and palate, for whom the possibility of secondary iatrogenic effects on nasal appearance must be carefully considered. 15,16,19,20 Cephalometric and anthropometric studies documenting the soft tissue changes after Le Fort I advancement in patients with cleft lip and palate have noted thinning of the upper lip, 3 shortening of the nose, increased nasal tip projection, 10,17 and alar widening.…”

mentioning

confidence: 99%

“…[5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] Previous reports have examined the effect of maxillary advancement on nasolabial configuration, predominantly in patients without cleft lip and palate, for whom the possibility of secondary iatrogenic effects on nasal appearance must be carefully considered. 15,16,19,20 Cephalometric and anthropometric studies documenting the soft tissue changes after Le Fort I advancement in patients with cleft lip and palate have noted thinning of the upper lip, 3 shortening of the nose, increased nasal tip projection, 10,17 and alar widening. 10,15,17,18 Laser scanning has been used to measure the cheek, perialar, and nasal projection in patients with cleft lip and palate before and after Le Fort 11 and to follow the occurrence of relapse over time.…”

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confidence: 99%

Does the Nostril Shape Change After Le Fort I Advancement in Patients With Unilateral Complete Cleft Lip?

Ganske

Tan

Langa

et al. 2020

Journal of Oral and Maxillofacial Surgery

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Patients with unilateral cleft lip and palate (UCLP) may require Le Fort I advancement to correct maxillary hypoplasia after reaching skeletal maturity. The underlying cleft anatomy, previous operations, and scarring can affect nostril changes after maxillary advancement. The purpose of the present study was to determine whether Le Fort I advancement affects the nostril configuration (ie, width, axis, shape) in patients with UCLP. The specific aims were to (1) compare cleft and noncleft nostrils in patients with UCLP after maxillary advancement and (2) compare the changes in nostril configuration in patients with UCLP with those in noncleft controls after Le Fort advancement. Patients and Methods: A retrospective case-control study of nonsyndromic, skeletally mature patients with UCLP and a case-matched control group without UCLP who had undergone single-piece Le Fort I advancement with alar cinch suture from 2010 to 2014. Patients were included if they had undergone pre-and postoperative 3-dimensional photogrammetry without intervening nasal revision. Threedimensional anthropometry was used to evaluate changes in nostril axis and width, soft triangle angle, columellar show, and nasal width after orthognathic correction. Results: The present study included 19 patients with UCLP (11 males; mean age, 18.0 years) and 19 noncleft controls (11 males; mean age, 18.7 years; P = .276). The mean sagittal advancement in the patients with UCLP and noncleft controls was 7.5 mm and 6.3 mm, respectively (P = .143). On average, the nostrils widened, the soft triangles flattened, and the columellar show increased. No significant difference was found in the changes to the nostril configuration between the cleft and noncleft sides in the patients with UCLP. No significant differences were found in the nostril changes between patients with UCLP and noncleft controls. Conclusions: Baseline nostril asymmetry is not altered by Le Fort osteotomy in patients with UCLP because both nostrils respond similarly to the deforming forces of maxillary advancement. Similarly, no differences were found in the nostril changes between the cleft and noncleft controls. These findings can aid proper surgical planning for cleft nasal revisions.

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Soft Tissue Changes in Cleft Lip and Palate Patients: Anterior Maxillary Distraction versus Conventional Le-Fort I Osteotomy

Abstract: The purpose of the study was

Cited by 17 publications

References 28 publications

Photometric Evaluation of Soft Tissue Changes in CLP Patients: Le Fort I Advancement Osteotomy (ALO) Versus Anterior Maxillary Distraction (AMD)

Photometric Evaluation of Soft Tissue Changes in CLP Patients: Le Fort I Advancement Osteotomy (ALO) Versus Anterior Maxillary Distraction (AMD)

Soft Tissue Profile Changes Following Orthodontic Treatment in Patients With Unilateral Cleft Lip and Palate

Does the Nostril Shape Change After Le Fort I Advancement in Patients With Unilateral Complete Cleft Lip?

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