The Millard Rotation-Advancement Cleft Lip Repair: 50 Years of Modification

Roussel, Lauren O.; Myers, René P.; Girotto, John A.

doi:10.1597/14-276

Cited by 24 publications

(20 citation statements)

References 55 publications

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“…Millard's design is based on the idea of "cut as -you-go" and is not based on precise measurements, these measurements are used as a guide with the arbitrary judgment for the newly trained surgeon (23,24) . Surgical Incisions Marking rotation flap (A) is 1 st ; which extends from point 3 (peak of cleft cupid's bow) to lip-columellar base as far as non-cleft philtral column but not crossing to another side.…”

Section: Methodsmentioning

confidence: 99%

Comparison of Rotation-Advancement and Straight-Line Methods for Repairing of Unilateral Cleft Lip (A Randomized Controlled Clinical Trial).

ammar

Elprince

Khalil

et al. 2022

Alexandria Dental Journal

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INTRODUCTION:A cleft is a universal and non-standardized defect. To overcome stigmatization; cleft repair is essential to normalize the facial appearance. Thus, different surgical techniques and modifications have been developed. These techniques are based on three surgical approaches: The straight-line (Rose-Thompson), rotation-advancement (upper lip Z-plasty), and the triangular flap (lower lip Z-plasty). OBJECTIVES: Comparing the effectiveness of rotation-advancement approach to the straight-line approach in repairing unilateral cleft lip. METHODOLOGY: A prospective control clinical trial of twelve patients with unilateral cleft lip (aged between 1-and 24 months) was conducted. These patients were randomly selected and equally divided into two groups of 6 participants, each group was operated on with Millard or Fisher incisions. Caliper measurements of the lip and nose were recorded preoperatively. The analysis was based on a quantitative and qualitative comparison of the cleft side versus the non-cleft side for 3 outcomes (the constructed philtral ridge, the degree of labial scar, and degree of nasal symmetry) which were all used to assess the aesthetic difference between the two incisions. These outcomes were measured postoperatively at 6 months. Both Chi-square and Mann Whitney tests were used for statistical comparison of outcomes. RESULTS:The nasal asymmetry improved in both groups with a better result in cases operated on with Fisher; which was statistically significant at (2.201 * (0.028 * ). Medial lip height was increased in both groups with no statistical significance. The difference was statistically significant for the increase of lateral lip height of both groups at a P-value of <0.05. CONCLUSION: Nasolabial appearance in both incisions was satisfactory. Lip dimensions were improved in both groups. Due to the ''BACK CUT'' use; the lateral lip height was better with the Millard. Meanwhile, the nasal symmetry showed better results with the Fisher due to the definite preoperative measurements. Therefore, neither Fisher nor Millard incision was predominantly better than the other.

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Section: Methodsmentioning

confidence: 99%

Comparison of Rotation-Advancement and Straight-Line Methods for Repairing of Unilateral Cleft Lip (A Randomized Controlled Clinical Trial).

ammar

Elprince

Khalil

et al. 2022

Alexandria Dental Journal

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“…The scans were acquired with an iCat machine (Imaging Sciences International, LLC, Hatfield, Pa) by the same radiology technician and with a 40-second scan, a 23 3 17-cm field of view (FOV), and a voxel size of 0.3 mm. The selection criteria included the presence of UCLP repaired by Millard's 10 and Veau's methods, 11 RME as an initial part of the orthodontic treatment, and absence of previous orthodontic treatment. The exclusion criteria were any additional craniofacial syndrome and the absence of erupted maxillary permanent first molars.…”

Section: Methodsmentioning

confidence: 99%

Upper airway assessment using four different maxillary expanders in cleft patients: A cone-beam computed tomography study

Mordente

Palomo

Horta

et al. 2015

The Angle Orthodontist

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“…Diagnostic imaging becomes essential when performing BG, in order to assess the size of the alveolar cleft defect, the position and level of bone tissue adjacent to the teeth, as well as the presence of supernumerary teeth. [12] [13] [14] [15] [16] After performing the BG, the radiological evaluation will allow to determine the results of the intervention, by assessing the bone filling of the defect, the eruption status of the lateral incisor or the canine adjacent to the cleft. The adequacy of the bone tissue for subsequent endosseous implantation will also be assessed.…”

Section: Conclusion: Radiological Evaluation Of Secondary Bone Grafting In the Cleft Area Inmentioning

confidence: 99%

Radiological evaluation of secondar y bone grafting results in patients with cleft lip and palate

Railean¹,

Porosencov²

2021

JSM

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Introduction. Bone grafts are a necessary component of the care protocol for patients with cleft lip and palate (CLP). Radiological evaluation is an essential tool in evaluating the integration of the bone graft at the cleft area. Aim: Evaluation of the interdental height of the alveolar ridge in patients with CLP at the pre- and postoperative stages in order to assess the integration of bone graft in the cleft area. Material and methods: Cross-sectional clinical study, which included 34 patients with CLP; with equal distribution by gender, with an average age of 17.6±0.43 years. The study group underwent surgical treatment with bone grafting in the cleft region. The radiological evaluation was performed pre- and postoperatively (over 6 months), according to the scale of assessment proposed by Abyholm et al. Statistical evaluation of the data was performed by the Pearson correlation coefficient. Results: Overall, favorable postoperative results were observed. Initially, according to the radiological evaluation, the patients presented at the preoperative stage type III 29.4% (n = 10) and type IV - 70.6% (n = 24) of the interdental height of the alveolar ridge. Following bone grafting, it was recorded at 52.9% (n = 18) - type I, mainly in female patients (n = 11) and 47.1% (n = 16) - type II of the interdental height of the alveolar ridge , being predominantly registered in male patients (n = 10). Statistically significant differences between the sexes were not recorded (p = 0.132). The successful results obtained by secondary bone grafting in the cleft region allowed to continue the rehabilitation treatment of patients with CLP. Conclusion: Radiological evaluation of secondary bone grafting in the cleft area in terms of assessing the height of the alveolar ridge according to the scale of Abyholm et al. is a valuable diagnostic tool, readily available for assessing the condition of the grafted bone.

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The Millard Rotation-Advancement Cleft Lip Repair: 50 Years of Modification

Cited by 24 publications

References 55 publications

Comparison of Rotation-Advancement and Straight-Line Methods for Repairing of Unilateral Cleft Lip (A Randomized Controlled Clinical Trial).

Comparison of Rotation-Advancement and Straight-Line Methods for Repairing of Unilateral Cleft Lip (A Randomized Controlled Clinical Trial).

Upper airway assessment using four different maxillary expanders in cleft patients: A cone-beam computed tomography study

Radiological evaluation of secondar y bone grafting results in patients with cleft lip and palate

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