Postoperative stability following orthognathic surgery and final skeletal morphology in class III patients with cleft lip and palate

Abstract

Orthognathic surgery has become useful procedures for patients with cleft lip and palate (CLP) to improve the inharmonious relationship between the maxilla and mandible. The purpose of this study is to assess the postoperative stability and skeletal morphology following orthognathic surgeries for patients with skeletal class III deformity with CLP. This study retrospectively evaluated the long-term stability of orthognathic surgery and the final profile of skeletal morphology in 30 patients using lateral cephalometric imaging. Sagittal split ramus osteotomy was performed for 10 patients (CLP-S), Le Fort I osteotomy was performed for 5 patients (CLP-L) and two-jaw surgery was performed for 15 patients (CLP-T). As a control, we included 5 patients treated by two-jaw surgery, 7 patients treated by SSRO without CLP and 20 CLP patients with orthodontic treatment alone. In the CLP group at 2 years postoperatively, the mean relapse in SNA was 19.8% (CLP-T) and 18.1% (CLP-L), and the mean relapse in SNB was 17.6% (CLP-S) and 26.9% (CLP-T). No significant differences were observed in the relapse ratio of the same operation between with and without CLP. In comparison of surgical and non-operative patients with CLP, there were significant differences in preoperative skeletal factors, but the profiles were similar at the end of treatment. Our orthognathic surgeries provided the same level of stability for patients with skeletal class III deformity with or without CLP, creating harmonious intermaxillary relationship.