Orthognathic Surgery in Cleft Patients Treated by Early Bone Grafting

A comparison of craniofacial cephalometric morphology and the later need for orthognathic surgery in 6-year-old cleft children

“…a more severe cleft than CL þ CP. The decision to undertake maxillary advancement is based on subjective assessment, usually without standardized criteria, and therefore, the decision for orthognathic correction is likely to vary among centres (Rosenstein et al, 1991). Good et al (2007) stated that the higher frequency of Le Fort I (47.4% in CLP patients) in their unit may reflect their preference for operative correction for all patients who have poor midfacial aesthetics despite their occlusal relationship.…”

“…Ross (1987b) has stated that roughly a quarter of men with UCLP require orthognathic surgery to achieve a functional occlusion. The frequency of Le Fort I osteotomy in UCLP and bilateral cleft lip and palate (BCLP) patients has been reported to be 22e48.3% (Rosenstein et al, 1991;Cohen et al, 1995;DeLuke et al, 1997;Good et al, 2007;Daskalogiannakis and Mehta, 2009). In addition to the improved occlusion, the treatment objectives include improved dentofacial appearance, and self-perception.…”

Possibilities and Limitations of Comprehensive Treatment of Mentally Retarded Patients with Cleft Lip, Alveolus and Palate

“…procedures of the jaws were reported by Rosenstein et al [22], Ross [15], and Deluke et al [6] to be indicated in approximately 25% of their patients. Various authors confirmed the stability of orthognathic surgery in cleft patients too [1,8,11].…”

“…Der Vorteil möglichst atraumatischer Operationstechniken wurde mehrfach nachgewiesen [4,14,15,20]. Unabhängig von der Spaltversorgung im Kindesalter fanden Rosenstein et al [22], Ross [15] und Deluke et al [6] bei etwa 25% ihrer Patienten eine Indikation für die chirurgische Umstellungs- interventions, osteoplasty with defect coverage by autogenous bone grafting was indicated. Intraoperatively, a 23 mm wide alveolar cleft was revealed.…”

Pediatric Vascularized Composite Allotransplantation

“…Although adults with nonsyndromic unrepaired cleft palates exhibit normal facial growth, 64,65 up to 25% of patients treated in infancy for cleft palate show evidence of midface retrusion requiring orthognathic surgery. 66,67 Maxillary and frontofacial osteotomies in a growing child make secondary corrective procedures very likely 68,69 ; therefore, these are generally deferred until facial growth is completed (17 and 18 years of age for female and male subjects, respectively 70 ). Caterson et al 71 reported performing a second Le Fort III procedure in 63% of the syndromic craniosynostosis patients who had undergone early primary subcranial Le Fort III.…”