Horizontal Maxillary Osteotomy Stability Using Mandibular Outer Cortex Bone Grafts in Patients With Cleft Lip and Palate.

OBJECTIVE

To investigate horizontal maxillary osteotomy stability after using bone grafts for the treatment of patients with unilateral cleft lip and palate (UCLP).

DESIGN

Retrospective cohort study.

SETTING

Plastic surgery hospital.

PATIENTS: Fifty-eight patients with UCLP and maxillary hypoplasia requiring a maxillary Le Fort I advancement of 6 to 9 mm.

INTERVENTIONS: The test group (TG) was comprised of 28 patients who underwent mandibular outer cortex bone grafting in the gaps created by a modified Le Fort I osteotomy. The control group (CG) was comprised of 30 patients who underwent a Le Fort I osteotomy without bone grafts.

MAIN OUTCOME MEASURES: Maxillary horizontal advancement (recorded during the operation using a Vernier caliper) and horizontal relapse at 12 months after surgery (based on a manual cephalometric analysis of pre- and postoperative lateral teleradiographs).

RESULTS

In the TG, the mean maxillary horizontal advancement was 7.13 ± 0.7 mm (range: 6.01-8.23 mm), and the mean postoperative horizontal relapse was 25.07 ± 6.64%. In the CG, the mean maxillary horizontal advancement was 6.90 ± 0.55 mm (range: 6.05-7.39 mm), and the mean postoperative horizontal relapse was 24.89 ± 4.25%. There were no significant between-group differences in the mean horizontal relapses.

CONCLUSION

The use of mandibular outer cortex bone grafts as physical barriers in patients with UCLP does not increase postoperative stability when the maxillary advancement is 6 to 9 mm.