Anterior maxillary distraction for maxillary advancement in growing patients with cleft lip and palate : Soft and hard tissue changes.

INTRODUCTION

Surgically facilitated anterior maxillary distraction (AMD) is used for the treatment of maxillary hypoplasia secondary to cleft lip and palate (CLP). In this study, the soft and hard tissue changes following AMD in growing patients with CLP were evaluated to determine the extent of changes that occurred.

METHODS

Cephalometric records of 8 growing patients with maxillary hypoplasia secondary to CLP were obtained. They were treated with AMD using a modified hyrax appliance. The preoperative (T1) and postoperative records (T2: after 1 year of consolidation and growing period) were analyzed using Dolphin software (version 11.95; Dolphin Imaging, Chatsworth, CA USA) and subjected to statistical analyses. Cephalometric analysis was performed by the same operator.

RESULTS

The values of SNA, U1-NA, U1-PP, U1-SN, L1-NB, AO-BO, OCC-SN angle, Sn-St increased significantly after the AMD procedure (p < 0.05). However, the soft tissue parameters nasolabial angle (Cm-Sn-Ls), facial height ([Gla]-Sn), and mentolabial sulcus depth (LiPo-Sm) did not show statistically significant changes (p < 0.05).

CONCLUSION

These results concur that AMD produced midfacial profile changes in patients with CLP. After AMD, the negative overjet decreased and proclination of the upper incisors was observed. Soft tissue parameters did not show statistically significant changes during the study period. The study proved that changes to correct the class III malocclusion occur primarily in the hard tissue and the results were significant.