Long-term folow-up after distraction osteogenesis with face mask in cleft lip and palate patients - preliminary report
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Published on: May 23, 2020
Dorota Cudziło1, Teresa Matthews-Brzozowska
1Poradnia Ortodontyczna dla Dzieci, ul. M. Kasprzaka 17a, 01-211 Warszawa, dcudzilo@gmail.com.
Introduction:
Patients with cleft lip and palate are often diagnosed with maxillary deficiency, i.e. the reduction of maxillary measurements in three dimensions. The method of distraction osteogenesis (DO) remedies the disorder caused by bone insufficiency by generating new bone tissue. Despite the fact that DO has long been considered an effective method to treat significant bone deficiencies, it is still not a standard treatment applied by clinicians to manage underdevelopment, especially in the maxillary area. There is only a small number of publications concerning the long-term follow-up results of the use of that method to treat patients with cleft lip and palate.
The Objective:
Long-term analysis of dentoskeletal changes in cleft lip and palate patients treated with distraction osteogenesis and the use of a facial mask.
Material And Methods:
In 2001-2004, 30 patients with cleft lip and palate and related maxillary deficiency were treated by means of distraction osteogenesis and a facial mask. However, due to incomplete documentation, only 15 persons, having full medical documentation and a set of cephalometric radiographs taken in three specified time periods, were qualified for the study. The cephalometric analysis was performed on the following lateral head radiographs: pre-distraction images (T0), images taken after active distraction (T1) and 5 years after the completion of the distraction process (T2). A group of 12 persons participated in the 5-year follow-up measurements (T2).
Results:
Cephalometric assessment indicated that after the use of distraction osteogenesis, the maxilla advanced by the mean of 3.84 mm and the SNA angle increased by the mean of 2.76° (statistically significant data). The maxillary advancement was accompanied by downward mandibular rotation. Long-term assessment after 5 years indicated that the SNA angle was reduced by 0.64°.
Conclusions:
The use of distraction osteogenesis with a facial mask to manage maxillary deficiency deserves more attention. It requires a close cooperation of the orthodontic and surgical team, as well as high motivation on the part of the patient. In order to provide the final assessment of the long-term results, further studies need to be conducted on larger clinical material.
