Stability after Cleft Maxillary Distraction Osteogenesis or Conventional Orthognathic Surgery

Area of Science:

• Craniofacial Surgery
• Orthodontics
• Maxillofacial Reconstruction

Background:

• Maxillary hypoplasia is common in cleft lip and palate (CLP) patients.
• Surgical advancements aim to correct skeletal discrepancies and improve facial aesthetics.
• Comparing stability between distraction osteogenesis and conventional orthognathic surgery is crucial for long-term outcomes.

Purpose of the Study:

• To compare the skeletal stability of maxillary advancements in CLP patients.
• To evaluate outcomes following distraction osteogenesis versus conventional orthognathic surgery.

Main Methods:

• A retrospective study comparing two groups: distraction osteogenesis (DOG, n=11) and conventional orthognathic surgery (CONVG, n=7).
• Lateral cephalograms were analyzed at three time points: preoperatively (T1), postoperatively (T2), and follow-up (T3).
• Key skeletal and soft tissue parameters, including horizontal overjet, ANB angle, and vertical overbite, were measured and statistically analyzed.

Main Results:

• Distraction osteogenesis showed significant maxillary advancement (6.98 mm) with no significant changes from T2 to T3, indicating stability.
• Conventional orthognathic surgery resulted in initial overjet and ANB angle increases, with a significant increase in vertical overbite and a decrease in ANB angle from T2 to T3, suggesting some relapse.
• At follow-up, vertical overbite was significantly greater in the conventional group compared to distraction osteogenesis.

Conclusions:

• Distraction osteogenesis provides a stable maxillary position with upward vertical movement in CLP patients.
• Conventional orthognathic surgery may exhibit sagittal relapse and continued downward movement postoperatively.
• Maxillary advancement stability differs between distraction osteogenesis and conventional orthognathic surgery in CLP patients.