The Need for Orthognathic Surgery in Nonsyndromic Patients with Repaired Isolated Cleft Palate

Antonarakis, Gregory S.; Watts, Gertrude; Daskalogiannakis, John

doi:10.1597/13-080

Cited by 26 publications

(17 citation statements)

References 26 publications

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“…We expected that cleft type would negatively influence the postoperative velopharyngeal function, especially in those patients with uni-and bilateral cleft lip and palate and borderline velopharyngeal function. Interestingly, the cleft type did not affect the VPI features, although the need for a Le Fort I osteotomy is higher for a cleft lip and palate than for an isolated cleft palate (Antonarakis et al, 2015;Daskalogiannakis and Mehta, 2009). Existing literature on this subject remains scarce.…”

Section: Cleft Typementioning

confidence: 93%

“…The need for a Le Fort I osteotomy varies according to the cleft type. In recent literature, the lowest frequency found for a Le Fort I osteotomy was 13% and was performed for an isolated cleft palate (CP) (Antonarakis et al, 2015), whereas patients with a unilateral cleft lip and palate (UCLP) or a bilateral cleft lip and palate (BCLP) exhibited higher frequencies of 40%e76.5% (Daskalogiannakis and Mehta, 2009;Heli€ ovaara and Rautio, 2011;Heli€ ovaara et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

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The effects of Le Fort I osteotomy on velopharyngeal function in cleft patients

Alaluusua

Turunen

Saarikko

et al. 2019

Journal of Cranio-Maxillofacial Surgery

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Introduction: Maxillary advancement may affect speech in cleft patients. The aim of this study was to evaluate whether preoperative velopharyngeal (VP) function and cleft type can predict VP function after a Le Fort I maxillary osteotomy. Materials and methods: One hundred consecutive nonsyndromic cleft patients (54 females, 64 males) who underwent Le Fort I osteotomies were retrospectively evaluated. Pre-and postoperative VP function was assessed perceptually and instrumentally by a Nasometer. A five-point scale was used to rate velopharyngeal insufficiency symptoms (VPI 0e4). To assess reliability, 30 video recordings were reevaluated. Results: Preoperatively, 89% of patients had normal or insignificant VPI (0e1), and only 3% had moderate VPI (3). Postoperatively, 77% of patients had VPI values of 0e1 and 14% had moderate to severe VPI values (VPI 3e4). A positive correlation was found between pre-and postoperative VPI scores, whereas the cleft type did not affect speech results. Patients with a preoperatively normal VPI (0) were not at risk for postoperative velopharyngeal incompetence. Conclusions: There was an overall significant negative change in speech after a Le Fort I osteotomy. Atrisk patients presented with borderline (1) or more severe VPI (2 and 3) preoperatively.

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Section: Cleft Typementioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

The effects of Le Fort I osteotomy on velopharyngeal function in cleft patients

Alaluusua

Turunen

Saarikko

et al. 2019

Journal of Cranio-Maxillofacial Surgery

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“…This may be explained by difference in clinical volume across centers and supports the feasibility of maintaining an elective practice in addition to cleft care for orthodontists at medium to low-volume centers (Figure 2). Additionally, orthodontists play a central role in developing a more robust program to address the unmet needs in cleft dental (Al Agili et al, 2004;Becker et al, 2009) and orthognathic care, (Ross, 1987;Shaw et al, 1992;Oberoi et al, 2008;Antonarakis et al, 2015;Park et al, 2015) which may prove beneficial not only to patients but also generate more revenue for the university/hospital system. This study is not without its limitations.…”

Section: Question Responsementioning

confidence: 99%

Cleft and Craniofacial Team Orthodontic Care in the United States: A Survey of the ACPA

Khavanin

Jenny

Jodeh

et al. 2019

The Cleft Palate-Craniofacial Journal

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Objective: To better understand the capacity for orthodontic care, service features, and finances among members of the American Cleft Palate-Craniofacial Association (ACPA). Design: Cross-sectional survey. Setting: ACPA-approved multidisciplinary cleft teams. Participants: Cleft team coordinators. Interventions: Coordinators were asked to complete the survey working together with their orthodontists. Main Outcome Measure: Model for orthodontic care. Results: Coordinators from 82 out of 167 teams certified by ACPA completed the survey (response rate = 49.1%). Most orthodontists were private practice volunteers (48%) followed by university/hospital employed (22.8%). Care was often delivered in community private practice facilities (44.2%) or combination of university and private practice facilities (39.0%). Half of teams reported offering presurgical infant orthopedics (PSIO), with nasoalveolar molding being the most common. Cleft/craniofacial patients typically comprise 25% or less of the orthodontists’ practices. The presence of a university/hospital-based orthodontist was associated with higher rates of offering PSIO ( P < .001) and an increased percentage dedication of their practice to cleft/craniofacial care ( P < .001). Conclusion: Orthodontic models across ACPA-certified teams are highly varied. The employment of full-time craniofacial orthodontists is less common but is highly correlated with a practice with a high percentage of cleft care and the offering of advanced services such as PSIO. Future work should focus on how to effectively promote such roles for orthodontists to ensure high-level care for cleft/craniofacial patients requiring treatment from infancy through skeletal maturity.

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“…According to a cross-sectional study conducted in Chinese school children, the prevalence of Class III malocclusion was relatively higher than other ethnics with a rate of 12.6% [2]. Class III malocclusion significantly affects oral function and facial aesthetics, and there is a tendency for this to worsen with age [3, 4]. Therefore, the high prevalence and adverse effects of Class III malocclusion have made it a serious public health problem.…”

Section: Introductionmentioning

confidence: 99%

Impact of surgical orthodontic treatment on quality of life in Chinese young adults with class III malocclusion: a longitudinal study

Song

Zhou

2019

BMC Oral Health

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Background The quality of life in Class III malocclusion patients are worse than those without the disorder and previous studies have shown that surgical orthodontic treatment has a different effect on these patients compared with mild or moderate malocclusion. This study aimed to investigate the changes in quality of life in patients with Class III malocclusion during surgical orthodontic treatment in Chinese young adults. Methods The 14-item Short Form Oral Health Impact Profile (OHIP-14), and the 22-item Orthognathic Quality of Life Questionnaire (OQLQ) were used to assess the effect of surgical orthodontic treatment on the quality of life in 21 patients with Class III malocclusion at pre-treatment ( T 0 ), pre-surgical orthodontic treatment (6 to 8 months, T 1 ) and post-surgical orthodontic treatment (6 to 8 months after surgery, T 2 ), and 24 healthy individuals were included as controls. The comparisons in numerical variables between patients and controls were performed using Mann-Whitney U test. The scores of the two questionnaires between T 0 , T 1 , T 2 and controls ( T c) were compared using generalized estimating equation. Results According to OHIP-14 questionnaire, the mean scores in T 0 and T 1 were higher than those in T 2 and T c ( P < 0.001), and a significant decrease was observed after post-surgical orthodontic treatment ( P < 0.001), which achieved a level similar to the control group ( P > 0.05). As to OQLQ questionnaire, the mean scores of all domains showed a significant increase between T 0 and T 1 except for awareness of dentofacial aesthetics ( P > 0.05) and social aspects of dentofacial deformity ( P > 0.05), followed by a significant decrease between T 1 and T 2 . Conclusion Surgical orthodontic treatment may improve quality of life in patients with Class III malocclusion, but pre-surgical orthodontic treatment may have an adverse effect on quality of life.

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The Need for Orthognathic Surgery in Nonsyndromic Patients with Repaired Isolated Cleft Palate

Cited by 26 publications

References 26 publications

The effects of Le Fort I osteotomy on velopharyngeal function in cleft patients

The effects of Le Fort I osteotomy on velopharyngeal function in cleft patients

Cleft and Craniofacial Team Orthodontic Care in the United States: A Survey of the ACPA

Impact of surgical orthodontic treatment on quality of life in Chinese young adults with class III malocclusion: a longitudinal study

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