title: Craniofacial team management in Apert syndrome.
abstract: BACKGROUND
  Apert syndrome is one of the rarest of the craniosynostosis syndromes. Affected persons have extensive structural and functional impairments, some of which can be life threatening. Management requires team care from infancy to adulthood. The purposes of this article are to assess the outcomes in individuals with Apert syndrome after completion of treatment and to review current protocols for craniofacial team care and dental, orthodontic, and orthognathic surgical management.
  
  
  METHODS
  This was a retrospective cohort study of 8 subjects with Apert syndrome. Cephalograms at 2 time points were compared: adolescence (before midface advancement) and at least 1 year after advancement. The cephalometric values were compared with paired t tests. Team protocols are delineated.
  
  
  RESULTS
  Measurements indicating forward positioning of the maxilla increased significantly: SNA by 10.7° (P = 0.002) and midface length by 9.6 mm (P = 0.002). Sagittal jaw relationship improved significantly as well: ANB by 14° (P = 0.004) and the Wits appraisal by 8 mm (P = 0.003). Vertical dimensions also increased.
  
  
  CONCLUSIONS
  All individuals had significantly improved and stable positions of the midface and normalized facial profiles after treatment.
authors.affiliation: Department of Orofacial Sciences, School of Dentistry, University of California at San Francisco, CA, USA. sneha.oberoi@ucsf.edu
authors.forename: Snehlata
authors.initials: S
authors.lastname: Oberoi
authors.forename: William Y
authors.initials: WY
authors.lastname: Hoffman
authors.forename: Karin
authors.initials: K
authors.lastname: Vargervik
mesh_terms: D000168:Acrocephalosyndactylia / Q000601:surgery* / Q000628:therapy; D000293:Adolescent; D002508:Cephalometry; D002985:Clinical Protocols; D003730:Dental Care for Persons with Disabilities; D005147:Facial Bones / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D009971:Orthodontics, Corrective; D056948:Orthognathic Surgical Procedures; D019340:Osteotomy, Le Fort; D010348:Patient Care Team; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult