Prospective study of the sagittal growth of the maxilla in patients with maxillary unilateral complete cleft lip and palate operated at 6 months of age under a functional technique

Introduction: One of the common consequences of the surgical treatment of cleft palate patients is the excessive maxillary retrusion, which has not only aesthetic consequences but can also cause a psychological problem affecting their insertion in the social and work environment. The aim of this study was to determine whether the functional surgical repair of the lip in a same group of patients with maxillary unilateral complete cleft lip and palate, operated at 6 months of age, allows a normal sagittal development of the maxilla, both in the stage of mixed and permanent dentition, with a 8 year-long monitoring of this group of patients, and comparing the sagittal maxillary growth between these two periods.

Materials and methods: Cohort study of a sample formed by a group of 9 patients with maxillary unilateral complete cleft lip and palate, lip-operated at 6 months of age by the same surgeon under the functional technique described by Delaire. A teleradiography of conventional profile was taken in two periods of their lives and was analyzed on the basis of the Structural and Architectural Analysis of Delaire in 2004 for the mixed dentition and 2012 for the permanent dentition. To determine the sagittal maxillary growth, the analysis of the anterior facial pillar angle (C1/F1) was used, expected and real. The measurement was made by two trained maxillofacial surgeons and the Cohen’s Kappa Test was applied to check the correspondence in the measurements. Thus, the veracity of the data obtained was guaranteed. The non-parametric signed-rank Wilcoxon test was used in the statistical analysis and a difference was considered to be significant if the p -value was lower than 5%.

Results: No statistically significant difference was found when the expected and real angle (C1/F1) were analyzed both in the year 2004 and the year 2012, being the p -value higher than 5%. There was a positive sagittal maxillary growth that remained inside the parameters expected and considered as normal for the patients in the two periods analyzed.

Conclusion: The sagittal growth of the maxilla in the lip-operated patients at 6 months of age with functional criterion has remained normal in the last years, within the expected parameters, determined cephalometrically. The results show that it is possible to prevent or reduce to a large extent the sagittal underdevelopment of the maxilla when a surgical functional technique is used, reaching a normal sagittal growth of the maxilla, according to the expectations for each patient.

Key words: cleft lip–palate; cleft surgery; Delaire

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Jan 20, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on Prospective study of the sagittal growth of the maxilla in patients with maxillary unilateral complete cleft lip and palate operated at 6 months of age under a functional technique
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