Comparing Surgical Advancement Outcomes of Retruded Maxilla in a Group of Egyptian Cleft Lip and Palate Subjects
DOI:
https://doi.org/10.3889/oamjms.2022.7433Keywords:
Maxillary retrognathism, Cleft, Dental retrusion, Surgical advancementAbstract
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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Copyright (c) 2022 Aida M. Mossaad, Mostapha A. Abdelrahman, Suzan A. Hassan, Hatem H. Al Ahmady, Nahed M. Adly, Wael A. Ghanem, Shadia A. Elsayed (Author)
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