J Korean Assoc Oral Maxillofac Surg.  2000 Aug;26(4):407-413.

Stability of orthognathic surgery for cleft lip and palate patients

• Kwon TG
• Mori Y
• Minami K
• Kim JB

Abstract

To evaluate the stability after orthognathic surgery in cleft lip and palate patients using rigid fixation, 20 patients underwent primary repair in childhood and later developed a jaw deformity and malocclusion that required orthognathic surgery were reviewed. Two groups, one of 10 patients performed Le Fort I osteotomy with sagittal split ramus osteotomy and one of 10 patients with sagittal split ramus osteotomy of the mandible, were evaluated. Each group had unilateral cleft only and all alveolar cleft sites had been grafted with autogeneous bone before the orthognathic surgery. The amount of surgical movement and relapse were compared in both horizontal and vertical dimensions. Two-jaw surgery group was more stable than mandibular surgery only group in mandibular position (p< 0.05). Statistically significant relapse was observed in mandibular skeletal point in mandibular surgery group (p<0.05). There was no statistically significant relapse in the skeletal point of two-jaw surgery group. However, the correlation between the horizontal surgical movement and relapse was detected (r = 0.88). This correlation indicates the need of overcorrection. The presence of scar tissues and relatively deficient maxillary bone could be attributed to this close relation between the surgical change and relapse.

Keyword

Cleft Lip and Palate; Orthognathic surgery; Cephalometric analysis

MeSH Terms

Cicatrix
Cleft Lip*
Congenital Abnormalities
Humans
Jaw
Malocclusion
Mandible
Maxilla
Orthognathic Surgery*
Osteotomy
Osteotomy, Sagittal Split Ramus
Palate*
Recurrence
Transplants
Vertical Dimension