Gingivosupraperiosteoplasty following Presurgical Maxillary Orthopedics Is Associated with Normal Midface Growth in Complete Unilateral and Bilateral Cleft Patients at Mixed Dentition
| Autor: | Mislen Bauer, S. Anthony Wolfe, Martha Mejia, Erin M. Wolfe, Ana Tejero, Leonard Rothenberg, Blake D. Murphy |
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| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Complete bilateral cleft lip Dentition Mixed Cephalometry Cleft Lip Orthodontic Appliances Periosteum Maxilla medicine Humans Maxillofacial Development Mixed dentition Gingivoplasty Orthodontics business.industry Lateral cephalograms Infant Newborn Infant Skeletal maturity medicine.disease Cleft Palate stomatognathic diseases Treatment Outcome Palatal Obturators Bilateral cleft lip Clinical question Face Orthopedic surgery Female Surgery Malocclusion business |
| Zdroj: | Plastic & Reconstructive Surgery. 148:1335-1346 |
| ISSN: | 0032-1052 |
| DOI: | 10.1097/prs.0000000000008582 |
| Popis: | BACKGROUND Passive orthodontic appliances and gingivosupraperiosteoplasty are adjuncts that can be used by surgeons at the time of primary cleft lip repair. These treatments, along with the surgical technique of cleft lip and palate repair, may impact midface growth. The objective of this study was to describe the authors' protocol for unilateral and bilateral cleft lip repair and to evaluate midfacial growth in a cohort of patients at mixed dentition who had undergone presurgical passive orthodontic appliance therapy and gingivosupraperiosteoplasty at the time of unilateral and bilateral cleft lip repair. METHODS Fifteen complete unilateral and 15 complete bilateral cleft lip and palate patients underwent passive orthodontic appliance treatment and primary lip repair with gingivosupraperiosteoplasty. Lateral cephalograms were analyzed by three blinded reviewers. Mean cephalometric measurements at mixed dentition were compared to cephalometric values for noncleft patients, unilateral cleft lip and palate patients who did not undergo gingivoperiosteoplasty or presurgical treatment, and unilateral cleft lip and palate patients who underwent gingivoperiosteoplasty/nasoalveolar molding with independent samples t tests. RESULTS Mean cephalometric values were within age-specific normal values for sella-nasion-A point, sella-nasion-B point, A point-nasion-B point, and facial axis. Eighty-seven (13/15) percent of unilateral cleft lip and palate patients and 93 percent (14/15) of bilateral cleft lip and palate patients did not exhibit skeletal class III malocclusion. There was no significant difference between cephalometric values for our patients and patients who did not receive gingivosupraperiosteoplasty or presurgical treatment or who underwent the gingivoperiosteoplasty/nasoalveolar molding protocol. CONCLUSIONS Presurgical passive orthodontic appliances, combined with gingivosupraperiosteoplasty at the time of lip repair, leads to normal maxillary development in most patients at mixed dentition. Assessment of midface growth at skeletal maturity is required. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, IV. |
| Databáze: | OpenAIRE |
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