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Cleft lip and palate, orthognathic surgery

Hideyuki Suenaga, Asako Taniguchi, Kazumichi Yonenaga, Kazuto Hoshi, Tsuyoshi Takato
INTRODUCTION: Computer-assisted preoperative simulation surgery is employed to plan and interact with the 3D images during the orthognathic procedure. It is useful for positioning and fixation of maxilla by a plate. We report a case of maxillary retrusion by a bilateral cleft lip and palate, in which a 2-stage orthognathic procedure (maxillary advancement by distraction technique and mandibular setback surgery) was performed following a computer-assisted preoperative simulation planning to achieve the positioning and fixation of the plate...
October 4, 2016: International Journal of Surgery Case Reports
Dimitrios Kloukos, Piotr Fudalej, Patrick Sequeira-Byron, Christos Katsaros
BACKGROUND: Cleft lip and palate is one of the most common birth defects and can cause difficulties with feeding, speech and hearing, as well as psychosocial problems. Treatment of orofacial clefts is prolonged; it typically commences after birth and lasts until the child reaches adulthood or even into adulthood. Residual deformities, functional disturbances, or both, are frequently seen in adults with a repaired cleft. Conventional orthognathic surgery, such as Le Fort I osteotomy, is often performed for the correction of maxillary hypoplasia...
September 30, 2016: Cochrane Database of Systematic Reviews
Jun-Zi Yingwang, Shun-Yao Shen, Biao Li, Hao Sun, Xu-Dong Wang
PURPOSE: To establish a three dimensional spacial measurement method to analyze the short-term stability of maxilla after orthognathic surgery in cleft lip and palate patients. METHODS: Twenty-five patients with maxillary hypoplasia secondary to cleft lip and palate seeking for orthognathic surgery were included in this study between January 2008 and September 2012. The spiral CT scan for the skull were taken 6 weeks preoperatively (T0), 4 days postoperatively (T1),3 months postoperatively (T2), and 6 months postoperatively (T3) and collected...
June 2016: Shanghai Kou Qiang Yi Xue, Shanghai Journal of Stomatology
Arezoo Jahanbin, Mozhgan Kazemian, Iman Saeedi-Pouya, Neda Eslami, Hooman Shafaee
INTRODUCTION: Treatment of cleft lip and palate patients requires a multidisciplinary plan. These patients usually have a hypoplastic maxilla due to the prior surgical scars. Orthognathic surgery to advance the maxilla in these patients is not very efficient; therefore, orthopedic interventions during an appropriate age seems to be essential. CASE REPORT: In this article, two cleft lip and palate patients have been treated with Class III elastics anchored to the maxillary posterior and mandibular anterior miniplates in order to induce maxillary advancement...
July 2016: Iranian Journal of Otorhinolaryngology
Ramen Sinha, P Suresh Menon, M G Venugopal
BACKGROUND: Cleft lip and palate patients present large osseous defects of the alveolus and midface hypoplasia. Traditional orthognathic surgery has limitations of relapse and limited age group. Distraction osteogenesis (DO) as a modality for midface advancement is relatively new. Modular internal distractor (MID) offers the advantage of patient compliance and minimal discomfort. The purpose of this study was to evaluate the versatility of intraoral distractors in midface advancement...
July 2011: Medical Journal, Armed Forces India
Young-Wook Park, Kwang-Jun Kwon, Min-Keun Kim
BACKGROUND: Most of cleft lip and palate patients have the esthetic and functional problems of midfacial deficiencies due to innate developmental tendency and scar tissues from repeated operations. In these cases, maxillary protraction is required for the harmonious facial esthetics and functional occlusion. CASE PRESENTATION: A 7-year old boy had been diagnosed as severe maxillary constriction due to unilateral complete cleft lip and palate. The author tried to correct the secondary deformity by early distraction osteogenesis with the aim of avoiding marked psychological impact from peers of elementary school...
December 2016: Maxillofacial Plastic and Reconstructive Surgery
Frances Yoshikane, Li Han Lai, Brian K Hui, Deborah B Martins, Gina Farias-Eisner, Rachel S Mandelbaum, Han Hoang, James P Bradley, Libby Wilson, Justine C Lee
BACKGROUND: Understanding long-term sequelae of cleft treatment is paramount in the refinement of treatment algorithms to accomplish optimized immediate and long-term outcomes. In this study, we reviewed sphincter pharyngoplasties as a method of velopharyngeal insufficiency (VPI) treatment in relationship to orthognathic surgery. METHODS: Cleft lip/palate and cleft palate patients, 15 years of age and older, were reviewed for demographics, VPI surgery, revisions, and subsequent orthognathic surgery at 2 institutions...
April 2016: Plastic and Reconstructive Surgery. Global Open
Yilue Zheng, Ningbei Yin, Zhenmin Zhao, Xiaomei Sun, Chanyuan Jiang, Haizhou Tong, Hengyuan Ma, Tao Song
OBJECTIVE: To classify the patients with cleft lip and palate who need orthognathic surgery and to propose the corresponding operations. METHODS: From January 2005 to May 2015, 121 patients with cleft lip and palate diagnosed as maxillary retrusion were treated by orthognathic surgery. Inclusion criteriar: (1) male aged over 16, female aged over 14; (2) diagnosed as non-syndromic cleft lip and palate without systemic disease and other genetic diseases; (3) without previous orthodontic and orthognathic treatment; (4) having no other craniofacial malformation...
January 2016: Zhonghua Zheng Xing Wai Ke za Zhi, Zhonghua Zhengxing Waike Zazhi, Chinese Journal of Plastic Surgery
Mourad Sebbar, Amal El Aouame, Idriss Tougui
INTRODUCTION: Management of adult patients with a cleft lip and palate is often multidisciplinary. The aim of orthodontic treatment is to correct the malocclusion. When the skeletal dysmorphosis is significant, the solution has to be orthognathic surgery. OBSERVATION: The authors report the case of a 16-year-old patient with a cleft lip and palate and a skeletal Class III. The aim of the orthodontic treatment was to correct dento-alveolar compensations. The skeletal discrepancy was corrected by maxillary advancement and mandibular setback...
June 2016: International Orthodontics
G I Isiekwe, C O Oguchi, O O daCosta, I L Utomi
INTRODUCTION: Craniofacial orthodontics has been shown to be a critical component of the care of patients with craniofacial anomalies such as cleft lip and palate. Thus, the purpose of this study was to assess the perceptions and clinical experience in cleft and craniofacial care, of orthodontic residents in Nigeria. METHODOLOGY: Questionnaires were sent out to orthodontic residents in the six Postgraduate Orthodontic Training Centers in the country at that time...
May 2016: Nigerian Journal of Clinical Practice
Daniel Lonic, Betty Chien-Jung Pai, Kazuaki Yamaguchi, Peerasak Chortrakarnkij, Hsiu-Hsia Lin, Lun-Jou Lo
BACKGROUND: Although conventional two-dimensional (2D) methods for orthognathic surgery planning are still popular, the use of three-dimensional (3D) simulation is steadily increasing. In facial asymmetry cases such as in cleft lip/palate patients, the additional information can dramatically improve planning accuracy and outcome. The purpose of this study is to investigate which parameters are changed most frequently in transferring a traditional 2D plan to 3D simulation, and what planning parameters can be better adjusted by this method...
2016: PloS One
En Luo, Shimao Yang, Wen Du, Qianming Chen, Chuhang Liao, Wei Fei, Jing Hu
BACKGROUND: Hemifacial microsomia (HFM) is the second most common congenital craniofacial deformity after cleft lip and palate. Distraction osteogenesis (DO) is regarded as an alternative and efficient treatment option for patients with HFM. However, DO was not proven effective for all cases, and the results of long-term follow-up were not satisfactory as expected. Compared with DO, the orthognathic surgery approach may offer more stable clinical outcomes for this kind of disease. The purpose of this study is to evaluate the long-term clinical and radiographic outcome of bimaxillary orthognathic surgery in the treatment of adult HFM...
June 2016: Aesthetic Plastic Surgery
Poonsak Pisek, Montian Manosudprasit, Tasanee Wangsrimongkol, Suthin Jinaporntham, Opas Wiwatworakul
This article aimed to present a case of 22 year-old Thai female with cleft lip and palate who had malocclusion developed from dental problems, skeletal disharmony and unrepaired alveolar cleft. The treatment was orthodontic combined with one-stage surgical correction which corrected skeletal discrepancy and alveolar cleft in single operation. After treatment, the patient had improved in facial esthetics, attaining good occlusal function and continuous maxillary dental arch. This procedure can reduce morbidity, preclude a second hospitalization and the cost of two-stage surgical correction...
August 2015: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
Kazuaki Yamaguchi, Daniel Lonic, Lun-Jou Lo
BACKGROUND/PURPOSE: The purpose of this systematic review is to update the available data for complications following orthognathic surgery in cleft lip and/or palate patients. METHODS: Three electronic databases (Medline, Embase, and Cochrane) were searched for publications from 1990 to 2014. RESULTS: A total of 26 articles were selected including 1003 patients (male: 391, female: 353, 259: not mentioned) who underwent maxillary osteotomies for cleft lip/palate...
April 2016: Journal of the Formosan Medical Association, Taiwan Yi Zhi
Kelley M Dentino, Daniel Sierra-Vasquez, Bonnie L Padwa
PURPOSE: Patients with unilateral complete cleft lip and palate (UCLP) have a characteristic bilateral septal deformity, and septal deviation can be associated with turbinate hyperplasia, leading to paradoxical nasal obstruction. The purpose of the present study was to measure and compare the bony and mucosal dimensions of the inferior turbinate on the cleft and non-cleft sides in patients with UCLP. PATIENTS AND METHODS: We implemented a retrospective cohort study of patients with UCLP who had undergone computed tomography (CT) scan between 2002 to 2013...
April 2016: Journal of Oral and Maxillofacial Surgery
Edward Davidson, Anand R Kumar
Nasal aesthetic changes after cleft orthognathic surgery remain understudied. Previous scarring associated with prior cleft surgery may affect the predictability of outcomes after jaw surgery. This study evaluates changes in nasal aesthetics using three-dimensional photography after Le Fort I advancement in patients with nonsyndromic cleft-related maxillary hypoplasia. Cephalometric parameters were recorded pre- and postoperatively. Three-dimensional photogrammetric imaging analyzed changes in interalar width (IAW), internostril width (INW), nasal tip projection (NTP), collumelar length (CL), nasal labial angle (NLA), and nasal length (NL)...
October 2015: Journal of Craniofacial Surgery
Joseph S Antoun, Peter V Fowler, Hannah C Jack, Mauro Farella
INTRODUCTION: The purpose of this study was to investigate the effect of orthodontic treatment on oral health-related quality of life (OHRQoL) in groups of standard patients with severe malocclusions; cleft lip, cleft palate, or cleft lip and palate patients; and orthognathic surgery patients. METHODS: The study sample consisted of 83 consecutive patients undergoing treatment at the orthodontic unit of Christchurch Hospital, Christchurch, New Zealand, divided into 3 groups: 30 adolescents with severe malocclusions; 24 adolescents with cleft lip, cleft palate, or cleft lip and palate; and 29 adults with severe skeletal discrepancies requiring both orthognathic surgery and orthodontic treatment...
October 2015: American Journal of Orthodontics and Dentofacial Orthopedics
A Vigneron, B Morand, V Lafontaine, V Lesne, C Lesne, G Bettega
INTRODUCTION: Maxillary hypoplasia is a common sequela of cleft lip and palate. Its surgical treatment consists in a maxillary advancement by distraction or by conventional orthognathic surgery but morphological results are unpredictable. Our goal in this study was to see if the esthetical results (on the lip and the nose) of maxillary advancement were correlated to the preservation of lateral incisor space of the cleft side. PATIENTS AND METHOD: This retrospective study included 38 patients operated between 2002 and 2013...
November 2015: Revue de Stomatologie, de Chirurgie Maxillo-faciale et de Chirurgie Orale
Kristian Andersen, Martin Svenstrup, Thomas Klit Pedersen, Annelise Küseler, John Jensen, Sven Erik Nørholt
OBJECTIVES: To compare stability of maxillary advancements in patients with cleft lip and palate following distraction osteogenesis or orthognathic surgery. MATERIAL AND METHODS: HASH(0x3a42a58) INCLUSION CRITERIA: 1) cleft lip and palate, 2) advancement > 8 mm. Eleven patients comprised the distraction osteogenesis group (DOG). Seven patients comprised the orthognathic treatment group (CONVG). Skeletal and soft tissue points were traced on lateral cephalograms: T1 (preoperatively), T2 (after surgery), T3 (follow-up)...
April 2015: Journal of Oral & Maxillofacial Research
Tojan Chacko, Sankar Vinod, Varghese Mani, Arun George, K K Sivaprasad
Maxillary hypoplasia is a common developmental problem in cleft lip and palate deformities. Since 1970s these deformities have traditionally been corrected by means of orthognathic surgery. Management of skeletal deformities in the maxillofacial region has been an important challenge for maxillofacial surgeons and orthodontists. Distraction osteogenesis is a surgical technique that uses body's own repairing mechanisms for optimal reconstruction of the tissues. We present four cases of anterior maxillary distraction osteogenesis with tooth borne distraction device-Hyrax, which were analyzed retrospectively for the efficacy of the tooth borne device-Hyrax and skeletal stability of distracted anterior maxillary segment...
December 2014: Journal of Maxillofacial and Oral Surgery
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