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

Aida M. Mossaad; Mostapha A. Abdelrahman; Suzan A. Hassan; Hatem H. Al Ahmady; Nahed M. Adly; Wael A. Ghanem; Shadia A. Elsayed

doi:10.3889/oamjms.2022.7433

Authors

Aida M. Mossaad Department of Orodental Genetics, National Research Centre, Cairo, Egypt
Mostapha A. Abdelrahman Department of Orodental Genetics, National Research Centre, Cairo, Egypt
Suzan A. Hassan Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine for Girls, Al Azhar University, Cairo, Egypt
Hatem H. Al Ahmady Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine for Girls, Al Azhar University, Cairo, Egypt
Nahed M. Adly Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine for Girls, Al Azhar University, Cairo, Egypt
Wael A. Ghanem Department of Plastic Pediatrics, Ain Shams University, Cairo, Egypt
Shadia A. Elsayed Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine for Girls, Al Azhar University, Cairo, Egypt

DOI:

https://doi.org/10.3889/oamjms.2022.7433

Keywords:

Maxillary retrognathism, Cleft, Dental retrusion, Surgical advancement

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.

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