Long-Term Stability of Alveolar Bone Graft in Cleft Lip and Palate Patients

ABSTRACT Objectives: This study evaluated the long-term stability of maxillary protraction (MP) in patients with complete unilateral cleft lip and palate (UCLP) and identified factors influencing relapse and long-term outcomes. Materials and Methods: Twenty-three adolescents with UCLP who underwent MP therapy were recalled when craniofacial growth was close to completion. Subjects exhibiting reverse/positive overjets were assigned to unstable/stable groups. Lateral cephalometric measurements were made before treatment (T0), after active treatment (T1), and at the end of the growth spurt (T2). Results: About 63% of the subjects exhibited positive overjets during follow-up. The unstable group demonstrated higher B–x and Co–Gn distances than the stable group (both P < .05) at T0. More short-term (T0–T1) sagittal advancement of point A (A–y) was evident in the unstable group than in the stable group (P < .05), but no long-term difference was apparent between the two groups (P = .481). During the posttreatment period (T1–T2), the SNA angle and maxillary incisor protrusion (U1–SN angle) were considerably lower in the unstable group than in the stable group (both P < .05). Overall, the unstable group exhibited a lower increase in the vertical extent of point A (A–x) than the stable group from T0 to T2 (P < .05). Conclusions: In the long term, MP affords favorable maxillary advancement in patients with UCLP. A mandibular excess at T0 and vertical maxillary hypoplasia may contribute to the long-term relapse of a reverse overjet.

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Single Versus Segmental Maxillary Osteotomies and Long-Term Stability in Unilateral Cleft Lip and Palate Related Malocclusion

Journal of Oral and Maxillofacial Surgery ◽

10.1016/j.joms.2014.07.005 ◽

2014 ◽

Vol 72 (12) ◽

pp. 2514-2521 ◽

Cited By ~ 9

Author(s):

Guy D. Watts ◽

Gregory S. Antonarakis ◽

Christopher R. Forrest ◽

Bryan D. Tompson ◽

John H. Phillips

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Term Stability ◽

Long Term Stability ◽

Single Versus

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Treatment of Unilateral Cleft Lip and Palate Patient With Intraoral Tooth Tissue Borne Distractor and Facemask Therapy: A Case Report

The Cleft Palate-Craniofacial Journal ◽

10.1177/1055665621993366 ◽

2021 ◽

pp. 105566562199336

Author(s):

Akansha Bansal Agrawal ◽

Harshavardhan Kidiyoor ◽

Anand K. Patil Morth

Keyword(s):

Case Report ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Face Mask ◽

Rapid Maxillary Expansion ◽

Growth Potential ◽

Maxillary Expansion ◽

Long Term Stability ◽

Tooth Tissue

This case report demonstrates the successful use of intraoral distractor/hygenic rapid expander (HYRAX) for rapid maxillary expansion in anteroposterior direction with an adjunctive use of face mask therapy for anterior orthopedic traction of maxillary complex in a cleft patient with concave profile. The patient was a 13-year-old girl who reported with a chief complaint of backwardly positioned upper jaw and a severely forward positioned lower jaw. Therefore, a treatment was chosen in which acrylic bonded rapid maxillary expansion was done with tooth tissue borne intraoral distractor/HYRAX having a different activation schedule along with Dr Henri Petit facemask to treat maxillary retrognathism. As a result, crossbite got corrected and attained a positive jet with no bone loss in cleft area over a period of 5 months which was followed by fixed mechanotherapy achieving a well settled occlusion in 1 year. After completion of expansion and fixed mechanotherapy, ANB became +1 post-treatment which was −4 pretreatment. The prognathic profile was markedly improved by expansion and taking advantage of the remaining growth potential, thus minimizing the chances of surgery later in life. This provided a viable alternative to orthognathic surgery with good long-term stability.

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