Skeletal stability after maxillary advancement with orthognatic surgery in patients with cleft lip and palate

Abstract

Objective To investigate the skeletal stability after maxillary advancement with orthognatic surgery in patients with cleft lip and palate and the factors related to relapse.Methods 34 cleft lip and palate patients underwent modifiedLeFort I maxillary advancement osteotomy,29 of them also had BSSRO and/or genioplasty.The clinical follow-ups were no shorter than 12 months.Lateral cephalograms were taken at presurgery,immediately postsurgery and at least 1 year postsurgery.The positional change of point A and PNS and angular change of SNA were measured by serial cephalometric analysis.Results Horizontal advancement averaged (4.38±1.88) mm,and the mean relapse was (20.10±18.39) 0％.Downward surgical movement averaged (3.46±2.15) mm,and the vertical relapse was (34.78±32.89)％.∠SNA was 77.9° presurgicaly,82.3° immediately after surgery and 81.4°at least 1 year postoperatively.There was no significant correlation between surgical movement and postoperative relapse in the horizontal plane(P＞0.05),but had a significant positive correlation in the vertical plane (P＜0.05).Variance analysis of continuous follow-ups of 15 patients showed most of the relapse occurred in the first 3 months after surgery.Conclusions Maxillary surgical advancement in patients with CLP showed relapse to a certain extent.Most of the relapse occurred in the first 3 months after surgery.The vertical relapse was positively correlated with inferior surgical movement of the mandible. Key words: Orthognathic surgery; Cleft lip and palate; Maxillary advancement; Skeletal stability