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Long-term stability of maxillary protraction therapy in Class III patients with complete unilateral cleft lip and palate
Authors:Yixin Zhang  Zhen Fu  Haichao Jia  Yiping Huang  Xiaobei Li  Hao Liu  Weiran Li
Abstract:Objectives:This study evaluated the long-term stability of maxillary protraction (MP) in patients with complete unilateral cleft lip and palate (UCLP) and identified factors influencing relapse and long-term outcomes.Materials and Methods:Twenty-three adolescents with UCLP who underwent MP therapy were recalled when craniofacial growth was close to completion. Subjects exhibiting reverse/positive overjets were assigned to unstable/stable groups. Lateral cephalometric measurements were made before treatment (T0), after active treatment (T1), and at the end of the growth spurt (T2).Results:About 63% of the subjects exhibited positive overjets during follow-up. The unstable group demonstrated higher B–x and Co–Gn distances than the stable group (both P < .05) at T0. More short-term (T0–T1) sagittal advancement of point A (A–y) was evident in the unstable group than in the stable group (P < .05), but no long-term difference was apparent between the two groups (P = .481). During the posttreatment period (T1–T2), the SNA angle and maxillary incisor protrusion (U1–SN angle) were considerably lower in the unstable group than in the stable group (both P < .05). Overall, the unstable group exhibited a lower increase in the vertical extent of point A (A–x) than the stable group from T0 to T2 (P < .05).Conclusions:In the long term, MP affords favorable maxillary advancement in patients with UCLP. A mandibular excess at T0 and vertical maxillary hypoplasia may contribute to the long-term relapse of a reverse overjet.
Keywords:Maxillary protraction  Unilateral complete cleft lip and palate  Skeletal Class III malocclusion  Long-term stability
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