title: Effects of growth on maxillary distraction osteogenesis in cleft lip and palate.
abstract: OBJECTIVE
  The objective was to analyze the effects of growth on the long-term result of maxillary distraction osteogenesis (DO) in cleft lip and palate (CLP).
  
  
  METHODS
  Retrospective study of 24 CLP cases with long-term follow-up operated for maxillary DO using the Polley and Figueroa technique: 10 patients were distracted during growth, while 14 patients were operated after their growth spurt. Preoperative (T0), 6-12 months postoperative (T1), and ≥4 years postoperative (T2) cephalometric radiographs were evaluated. A classical cephalometric analysis was used to assess the treatment stability, and a Procrustes superimposition method was performed to assess local changes in the maxilla and the mandible.
  
  
  RESULTS
  At T0, the mean age was of 11.9 ± 1.4 years for growing patient, and 17.9 ± 3.5 years for patient treated after their growth spurt (P < 0.001). Between T0 and T1, a greater increase of the SNA was shown in growing patients (P = 0.036), but the relapse was more important between T1 and T2, with a significant decrease of the SNA (P = 0.002) and ANB (P = 0.032) compared to the patients treated after their growth spurt. Although not significant, growing patients showed greater rotations of their palatal plane and mandibular plane.
  
  
  CONCLUSIONS
  Maxillary DO in CLP does not correct the growth deficit inherent to the pathology. Overcorrection of at least 20% is advised during growth.
authors.affiliation: Département de chirurgie orthopédique et plastique pédiatrique, Hôpital Lapeyronie, CHRU, Montpellier, France; Department of Oral and Maxillofacial Surgery, Dalhousie University, Halifax, Canada.
authors.forename: Jean-Charles
authors.initials: JC
authors.lastname: Doucet
authors.forename: Christian
authors.initials: C
authors.lastname: Herlin
authors.forename: Michèle
authors.initials: M
authors.lastname: Bigorre
authors.forename: Caroline
authors.initials: C
authors.lastname: Bäumler
authors.forename: Gérard
authors.initials: G
authors.lastname: Subsol
authors.forename: Guillaume
authors.initials: G
authors.lastname: Captier
mesh_terms: D000293:Adolescent; D002508:Cephalometry / Q000379:methods; D002648:Child; D002971:Cleft Lip / Q000503:physiopathology / Q000601:surgery*; D002972:Cleft Palate / Q000503:physiopathology / Q000601:surgery*; D016267:External Fixators; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008334:Mandible / Q000473:pathology; D008437:Maxilla / Q000254:growth & development* / Q000473:pathology / Q000601:surgery; D009295:Nasal Bone / Q000473:pathology; D019857:Osteogenesis, Distraction / Q000295:instrumentation / Q000379:methods*; D019340:Osteotomy, Le Fort / Q000379:methods; D010159:Palate / Q000473:pathology; D012008:Recurrence; D012189:Retrospective Studies; D012399:Rotation; D012658:Sella Turcica / Q000473:pathology; D016896:Treatment Outcome
keywords: Cleft Lip; Cleft Palate; Distraction; Growth; Mandible; Maxilla