Infantile swallowing: surgical meaning

The aim of this retrospective work on 30 patients affected by dento-skeletal III class and Infantile Swallowing (I.S.), treated between 2006 and 2014, is to analyze the causes of eventual surgical relapses and to underline the consequences of untreated Infantile Swallowing. Infantile Swallowing can be correlated with a relapse in the surgical treatment and therefore requires investigation and treatment beforehand any surgical approach.

Between the 2006 and 2014 a number of 30 patients affected by III dento-skeletal class and I.S. were treated with a pre-surgery protocol, surgery and a post-surgery protocol. The surgical protocol consisted of: Le Fort I and Bilateral Sagittal Split Osteotomy (BSSO). Out of the 30 patients 3 received previous surgical treatment in another locality without going through pre- and post-surgery protocols for I.S., and they presented themselves about 14 months post-surgery to the first examination having a relapse of the dento-skeletal III class.

No skeletal relapse has ever been recorded today in the 30 patients treated with pre and post-surgery protocols and Le Fort I and BSSO osteotomy.

Relapses are commonly attributed to surgical errors or inappropriate surgical program only; in our analysis we observed that the 100% of relapses were due to an untreated or undiagnosed I.S. that caused derangement of bicortical screw and incorrect bony formation and consequently a sort of an improper "distraction osteogenesis".