Effects of growth on maxillary distraction osteogenesis in cleft lip and palate |
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| Authors: | Jean-Charles Doucet Christian Herlin Michèle Bigorre Caroline Bäumler Gérard Subsol Guillaume Captier |
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| Affiliation: | 1. Département de chirurgie orthopédique et plastique pédiatrique, Hôpital Lapeyronie, CHRU, Montpellier, France;2. Department of Oral and Maxillofacial Surgery, Dalhousie University, Halifax, Canada;3. Equipe ICAR-CNRS, LIRMM, Montpellier, France;4. Laboratoire d''anatomie de Montpellier, UFR Médecine, Université Montpellier 1, Montpellier, France;2. Faculty of Dentistry, Department of Orthodontics, Marmara University, Istanbul, Turkey;3. Faculty of Dentistry, Department of Prosthodontics, Marmara University, Istanbul, Turkey;4. Faculty of Dentistry, Department of Orthodontics, Marmara University, Istanbul, Turkey;1. Department of Plastic and Craniofacial Pediatric Surgery (Head: Guillaume Captier), Faculty of Medicine, University of Montpellier, France;2. Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Dalhousie University, Halifax, Nova Scotia, Canada;3. Department of Radiology, Faculty of Medicine, University of Montpellier, France;4. Laboratory of Anatomy, Faculty of Medicine, University of Montpellier, France;1. Department of Plastic and Craniofacial Pediatric Surgery (Head: Pr Guillaume Captier), Faculty of Medicine, University of Montpellier, 371 Avenue du doyen Gaston Giraud, 34295 Montpellier Cedex 5, France;2. Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Dalhousie University, Halifax, Nova Scotia, Canada;3. Laboratory of Anatomy, Faculty of Medicine, University of Montpellier, France;1. General Surgery Department, Cairo University, Cairo, Egypt;2. Medical Oncology Department, Cairo University, Cairo, Egypt;3. General Surgery Department, Ain Shams University, Cairo, Egypt;1. Plastic Surgery Resident Department of Plastic & Reconstructive Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD;2. Plastic Surgery Resident Department of Plastic & Reconstructive Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD;3. Associate Professor of Plastic & Reconstructive Surgery Department of Plastic & Reconstructive Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD;1. Department of Oral & Maxillofacial Surgery, Massachusetts General Hospital, Boston, MA, USA;2. Harvard School of Dental Medicine, Boston, MA, USA |
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| Abstract: | PurposeThe objective was to analyze the effects of growth on the long-term result of maxillary distraction osteogenesis (DO) in cleft lip and palate (CLP).Patients and methodsRetrospective study of 24 CLP cases with long-term follow-up operated for maxillary DO using the Polley and Figueroa technique: 10 patients were distracted during growth, while 14 patients were operated after their growth spurt. Preoperative (T0), 6–12 months postoperative (T1), and ≥4 years postoperative (T2) cephalometric radiographs were evaluated. A classical cephalometric analysis was used to assess the treatment stability, and a Procrustes superimposition method was performed to assess local changes in the maxilla and the mandible.ResultsAt T0, the mean age was of 11.9 ± 1.4 years for growing patient, and 17.9 ± 3.5 years for patient treated after their growth spurt (P < 0.001). Between T0 and T1, a greater increase of the SNA was shown in growing patients (P = 0.036), but the relapse was more important between T1 and T2, with a significant decrease of the SNA (P = 0.002) and ANB (P = 0.032) compared to the patients treated after their growth spurt. Although not significant, growing patients showed greater rotations of their palatal plane and mandibular plane.ConclusionsMaxillary DO in CLP does not correct the growth deficit inherent to the pathology. Overcorrection of at least 20% is advised during growth. |
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