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Maxillary shape after primary cleft closure and before alveolar bone graft in two different management protocols: A
Journal of Stomatology, Oral and Maxillofacial Surgery
|February 15, 2019
Summary
Functional cleft surgery protocols result in wider inter-canine distances and better premaxillary positioning by age five. Early lip closure protocols show narrower results, requiring long-term follow-up for definitive comparison.
Area of Science:
- Craniofacial surgery
- Pediatric surgery
- 3D imaging analysis
Background:
- Assessing surgical outcomes in cleft palate patients is challenging.
- Geometric morphometrics offers a novel approach to quantify palatal shape changes.
Purpose of the Study:
- To compare the palatal shape outcomes of two distinct cleft management protocols.
- To evaluate the efficacy of early lip closure versus functional, staged closure.
Main Methods:
- Two patient cohorts (n=10 and n=11) were analyzed.
- Cone-Beam Computed Tomography (CBCT) scans were taken at age 5.
- Geometric morphometrics analyzed palatal shape differences between protocols.
Main Results:
- Protocol 2 (functional approach) yielded significantly wider inter-canine distances.
- The premaxillary region was positioned more inferiorly in Protocol 1 (early lip closure).
Conclusions:
- Functional cleft surgery protocols demonstrate superior intermediate outcomes in palatal development.
- Further long-term studies are needed to confirm the lasting benefits of functional protocols.
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