Cleft-orthognathic surgery: complications and long-term results

Area of Science:

• Craniofacial Surgery
• Orthodontics
• Pediatric Plastic Surgery

Background:

• Adolescents born with cleft lip and palate often develop jaw deformities and malocclusion.
• Primary cleft repair in childhood may not fully address secondary skeletal discrepancies.
• Orthognathic surgery is frequently required to correct these deformities.

Purpose of the Study:

• To evaluate the complications and long-term results of orthognathic surgery in adolescents with clefts.
• To assess the efficacy of surgical interventions for residual fistulas, dental gaps, and malocclusion.
• To determine the stability and patient outcomes following these procedures.

Main Methods:

• Retrospective review of 116 adolescents (15-25 years) undergoing orthognathic surgery (Le Fort I, sagittal split osteotomies, genioplasty).
• Procedures addressed maxillary hypoplasia, oronasal fistulas, alveolar clefts, and malocclusion.
• Clinical and radiographic follow-up ranged from 1 to 7 years.

Main Results:

• High success rates for fistula closure (89%) and dental gap closure (92%).
• Excellent long-term stability of overjet (97%) and overbite (89%).
• Low complication rates, with no bone loss or infection; minor gingival recession in 5% of teeth.

Conclusions:

• Orthognathic surgery is a safe and reliable method for managing jaw deformities and malocclusion in adolescents with clefts.
• These procedures significantly improve oral health, dental function, and quality of life.
• The surgical outcomes provide a stable base for subsequent soft-tissue revisions.