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Effects of maxillary protraction combined with chin-cap therapy in unilateral cleft lip and palate patients
H Ishikawa1, S Kitazawa, H Iwasaki
1Department of Orthodontics, School of Dentistry, Hokkaido University, Sapporo, Japan.
Objective:
This study investigated the treatment effects of maxillary protraction combined with chin-cap therapy in complete unilateral cleft lip and palate patients at the deciduous and early mixed dentition stages.
Method:
Twenty-six Japanese children (10 boys and 16 girls) with complete unilateral cleft lip and palate were examined. All had undergone pushback operations for palatal repair at approximately 18 months of age. Maxillary protraction began between 5 and 7 years of age and continued for 10 to 38 months. Lateral cephalograms were used to analyze skeletal changes during the first and second years of treatment, and the relationship between pretreatment midfacial morphology and forward displacement of the maxilla during the first year was investigated.
Results And Conclusions:
During the first year of treatment, the mean increase in the ANB angle for all cases was 2.37 degrees. The forward displacement of the maxilla varied considerably, from 0.23 mm to 3.03 mm. The treatment response was significantly smaller in the second year, and no benefit from treatment longer than 1 year was established. The amount of maxillary forward displacement was significantly correlated with the pretreatment posterior upper facial height. Patients with smaller posterior upper facial height showed a poorer treatment response, whereas patients with a greater posterior upper facial height responded better to treatment. Individual differences in maxillary growth acceleration may be related to growth inhibition associated with postsurgical scar tissue on the palates.
