title: Mandibular effects of maxillary distraction osteogenesis in cleft lip and palate.
abstract: Maxillary distraction osteogenesis (DO) is a reliable treatment for severe maxillary deficiency in cleft lip and palate (CLP). The objective was to analyze its long-term effects on the mandible. A retrospective study of 24 CLP treated with maxillary DO using the Polley and Figueroa technique was done; patients were followed for more than 4 years. Preoperative (T0), 6-12 months postoperative (T1), and ≥ 4 years postoperative (T2) cephalometric radiographs were evaluated. A classical cephalometric analysis was used to assess treatment stability, and a Procrustes superimposition method was used to assess local changes in the shape of the mandible. The mean age of patients at T0 was 15.4 ± 4.1 years. SNA increased at T1 and T2 (P < 0.001), with no significant relapse between T1 and T2, indicating stability at 1 year after treatment (T0 = 72.4 ± 5.3°; T1 = 81.3 ± 6.2°; T2 = 79.9 ± 6.1°). SNB, facial angle, gonial angle, and symphyseal angle remained stable. Long-term analysis of the mandible demonstrated a minimal counter-clockwise rotation of the body (mandibular plane = -0.2 ± 3.2°) and ramus (-0.6 ± 4.3°). Maxillary DO in CLP had no significant effect on the shape or rotation of the mandible. The maxillary advancement remained stable after 1 year.
authors.affiliation: Département de Chirurgie Orthopédique et Plastique Pédiatrique, Hôpital Lapeyronie, CHRU Montpellier, France; Department of Oral and Maxillofacial Surgery, Dalhousie University, Halifax, Canada. Electronic address: jcdoucet@gmail.com.
authors.forename: J-C
authors.initials: JC
authors.lastname: Doucet
authors.affiliation: Département de Chirurgie Orthopédique et Plastique Pédiatrique, Hôpital Lapeyronie, CHRU Montpellier, France.
authors.forename: C
authors.initials: C
authors.lastname: Herlin
authors.affiliation: Département de Chirurgie Orthopédique et Plastique Pédiatrique, Hôpital Lapeyronie, CHRU Montpellier, France.
authors.forename: M
authors.initials: M
authors.lastname: Bigorre
authors.affiliation: Département de Chirurgie Orthopédique et Plastique Pédiatrique, Hôpital Lapeyronie, CHRU Montpellier, France.
authors.forename: C
authors.initials: C
authors.lastname: Bäumler
authors.affiliation: Equipe ICAR-CNRS, LIRMM, Montpellier, France.
authors.forename: G
authors.initials: G
authors.lastname: Subsol
authors.affiliation: Département de Chirurgie Orthopédique et Plastique Pédiatrique, Hôpital Lapeyronie, CHRU Montpellier, France; Laboratoire d'Anatomie de Montpellier, UFR Médecine, Université Montpellier 1, France. Electronic address: g-captier@chu-montpellier.fr.
authors.forename: G
authors.initials: G
authors.lastname: Captier
mesh_terms: D000293:Adolescent; D002508:Cephalometry; D002971:Cleft Lip / Q000601:surgery*; D002972:Cleft Palate / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008334:Mandible / Q000254:growth & development*; D008437:Maxilla / Q000601:surgery*; D019857:Osteogenesis, Distraction; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: cleft lip; cleft palate; distraction; growth; mandible; maxilla