Miniplate-anchored maxillary protraction in adolescent patients with cleft lip and palate: A literature review of study design, type and protocol, and treatment outcomes.

Abstract

To review the study design, type, protocol, and treatment outcomes of miniplate-anchored maxillary protraction (MAMP) in adolescent patients with unilateral or bilateral cleft lip and palate. Five retrospective and two prospective studies (n=138 patients) were selected as per the inclusion criteria. The study design, type, protocol of MAMP and the amount of skeletodental change were investigated. Two studies adopted type 1 (two miniplates at the infrazygomatic crest with a facemask), four studies adopted type 2 (four miniplates at the infrazygomatic crest and mandibular symphysis and use of intermaxillary elastics), and one study compared the two types. The mean start age was older than 10years except one study. The mean duration was less than 1year in two studies, between 1 and 2years in three studies, and more than 2years in two studies. The type 1 used 500g/side for 12-14h/d, and the type 2 used three increase methods (100, 200, 250g/side; 75, 150, 250g/side; 150, 200, and 250g/side) for 24h/d. The ranges of A point advancement were 0.5°-4.2° in ΔSNA and 1.7-5.6mm in ΔA-vertical reference plane, respectively. The ranges of rotation of the palatal plane, occlusal plane, and mandibular plane were -1.5° to 2.0°, -2.0° to 2.0°, -1.5° to 3.2°, respectively. The increase of overjet was ranged from 2.3 to 5.8mm. The MAMP therapy is effective for the correction of maxillary hypoplasia in adolescent cleft patients despite different types and protocols.