Outcomes of Maxillary Orthognathic Surgery in Patients with Cleft Lip and Palate: A Literature Review

Ganoo, Tulika; Sjöström, Mats

doi:10.1007/s12663-019-01217-w

Cited by 12 publications

(5 citation statements)

References 27 publications

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“…In a literature review of DO and CO performed on patients with CLP, no clear evidence was found regarding which technique provides the optimal aesthetic outcome and functional improvement [ 40 ]. Those authors speculated that DO causes higher levels of anxiety and distress in patients, as compared to patients who undergo CO [ 40 ]. Chua et al have also stated that DO may induce short-term distress in patients [ 41 ].…”

Section: Discussionmentioning

confidence: 99%

Skeletal stability after maxillary distraction osteogenesis or conventional Le Fort I osteotomy in patients with cleft lip and palate: A superimposition-based cephalometric analysis

Lundberg,

Al-Taai,

Levring Jäghagen

et al. 2024

Oral Maxillofac Surg

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Purpose The aim was to assess skeletal stability after maxillary advancement using either distraction osteogenesis (DO) or conventional Le Fort I osteotomy (CO) in patients with cleft lip and palate (CLP) or cleft palate (CP) utilising a new superimposition-based cephalometric method. Method This retrospective study included patients who were treated with DO (N = 12) or CO (N = 9). Sagittal and vertical changes after surgery, and skeletal stability at 18 months post-operatively were assessed with superimposition-based cephalometry, comparing lateral cephalograms performed pre-operatively (T0), post-operatively after CO or immediately after completed distraction in DO (T1), and at 18 months of follow-up (T2). Results The mean sagittal movements from T0 to T2 in the DO and CO groups were 5.9 mm and 2.2 mm, respectively, with a skeletal relapse rate of 16% in the DO group and 15% in the CO group between T1 and T2. The vertical mean movement from T0 to T2 in the DO and CO groups was 2.8 mm and 2.0 mm, respectively, and the skeletal relapse rate between T1 and T2 was 36% in the DO group and 32% in the CO group. Conclusion Sagittal advancement of the maxilla was stable, in contrast to the vertical downward movement, which showed more-extensive relapse in both groups. Despite more-extensive maxillary advancement in the DO group, the rates of skeletal relapse were similar.

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Section: Discussionmentioning

confidence: 99%

Skeletal stability after maxillary distraction osteogenesis or conventional Le Fort I osteotomy in patients with cleft lip and palate: A superimposition-based cephalometric analysis

Lundberg,

Al-Taai,

Levring Jäghagen

et al. 2024

Oral Maxillofac Surg

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“…In 80% of CL/P patients, this critical step in cleft care and management is required. (10) However, some studies indicate that if a patient has a normal velopharyngeal mechanism prior to surgery, they become borderline VPI and may acquire VPI in 12.5% of cases following orthognathic surgery. On the other hand, patients who already had VPI prior to the surgery do not experience a worsening of the disease.…”

Section: Introductionmentioning

confidence: 99%

“…(15) The majority of the studies mentioned above and other studies looked at maxillary progress using the traditional Le Fort I osteotomy as a one-piece maxilla. (10,14,15,17,18) A single study looked at the effects of moving only the anterior maxilla, while few studies investigated the impact of the SLF-1. (19,20) The aim of this study was to evaluate the effect of SLF-1 on the speech properties of CL/P adult patients.…”

Section: Introductionmentioning

confidence: 99%

Speech characteristics of cleft lip and palate patients after orthognathic surgery

Helal,

Eldibany,

Boshnaq

et al. 2024

Alexandria Dental Journal

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INTRODUCTION:The velopharyngeal (VP) sphincter is ineffective in individuals with cleft lip and palate (CL/P), among other abnormalities in the speech-producing structures. Premaxilla protrusion, posterior crossbite, and maxillary hypoplasia are common symptoms in adult CL/P patients. Thus, orthognathic surgery is typically necessary, which could involve a segmental Le Fort I (SLF-1) osteotomy. The VP function may be impacted in different ways by this procedure. OBJECTIVE: This study's objective was to assess SLF-1's impact on adult CL/P patients' speaking characteristics. METHODOLOGY: Nine patients between the ages of 15 and 25 who had a history of CL/P, a maxillary skeletal deformity that needed to be corrected, and chronic alveolar defects were chosen. All patients had their speech evaluated prior to surgery and six months later. This included videofluoroscopy, nasoendoscopy, nasometry, and auditory perceptual evaluation. Maxillary advancement was 4.1 mm on average. RESULTS: Except for three patients who developed hypernasal changes, postoperative findings for all parameters remained unchanged, according to nasometry results alone. CONCLUSION: This shows that advancement through SLF-1 has no impact on the VP function, and that there may be other factors that have a compensatory effect. KEYWORDS Segmental, Le Fort I, cleft palate, velopharyngeal, speech, orthognathic RUNNING TITLE: speech characteristics of cleft lib and palate patients after orthognathic surgery

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“…In some patients, however, the mandible is actually larger than the normal. [4,5] This creates the need for orthognathic correction in CL/P patients in almost 80% of cases, [9] and as stated by Ohrmann [10] "a link in the chain of cleft care modalities". It has been categorized by an Index of Orthognathic Functional Treatment Need (IOFTN) by Ireland et al, [11] to be in the highest rank as "very great need for treatment".…”

Section: Introductionmentioning

confidence: 99%

Novel Difficulty Index for Cleft Maxillary Orthognathic Surgery

Gaber,

Helal,

Al Kassaby

2023

Egyptian Dental Journal

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Purpose: this study aims to provide and suggest a difficulty index or score for anticipated challenges in orthognathic surgeries for the CL/P patient. Methods:This was a retrospective study, done by collecting data of orthognathic surgeries performed on CL/P patients in the period from December 2020 to March 2022. Patients included were those with retrognathic or hypoplastic maxilla, that had a history of cleft lip, cleft palate or both, and had either failed or skipped alveolar bone grafting, with or without oronasal fistulae, and had undergone LF-1 osteotomy to advance the maxilla. Proper description of the clinical and radiographic findings was collected for each patient, along with the subjective score and any occurring difficulties reported by the surgeon at the time of the surgery. An objective score was formulated and statistically correlated with the subjective score.Results: Patients included in this study summed up to be 9 patients. The subjects were 44% males with age range of 16 to 21 years. 78% had cleft lip with palate, and 22% were cleft lip only, with primary palate. Various difficulties were reported by the surgeon in each patient, with wide range of subjective scores. Spearman correlation showed a positive correlation of 0.866 between the subjective score and the proposed difficulty index. Conclusion:The proposed difficulty index proved to be a promising tool, permitting better planning and preparation in the future of these surgeries. More validation is required with studies of bigger sample size.

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Outcomes of Maxillary Orthognathic Surgery in Patients with Cleft Lip and Palate: A Literature Review

Cited by 12 publications

References 27 publications

Skeletal stability after maxillary distraction osteogenesis or conventional Le Fort I osteotomy in patients with cleft lip and palate: A superimposition-based cephalometric analysis

Skeletal stability after maxillary distraction osteogenesis or conventional Le Fort I osteotomy in patients with cleft lip and palate: A superimposition-based cephalometric analysis

Speech characteristics of cleft lip and palate patients after orthognathic surgery

Novel Difficulty Index for Cleft Maxillary Orthognathic Surgery

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