title: Single versus segmental maxillary osteotomies and long-term stability in unilateral cleft lip and palate related malocclusion.
abstract: OBJECTIVE
  To investigate the stability of single-piece versus segmental (2-piece) maxillary advancement in patients with unilateral cleft lip and palate (UCLP) treated using conventional Le Fort I orthognathic surgery.
  
  
  METHODS
  A retrospective study was undertaken in 30 patients with nonsyndromic UCLP treated with the same surgical and orthodontic protocol from 2002 through 2011. Standard lateral cephalometric radiographs were taken preoperatively, immediately postoperatively, and at least 1 year postoperatively. Patients were divided into single-piece and segmental Le Fort I groups based on planned surgical movement. Postoperative movements were compared between groups using repeated measures analysis of variance.
  
  
  RESULTS
  The mean skeletal horizontal advancement was 7.3 and 7.5 mm in the single-piece and segmental groups, respectively. The skeletal horizontal relapse was 1.3 mm (18%) for the single-piece group and 1.9 mm (25%) for the segmental group. The skeletal surgical extrusion was 2.7 mm for the 2 groups. The skeletal vertical relapse was 0.6 mm (22%) and 1.5 mm (56%) for the single-piece and segmental groups, respectively. The mean dental horizontal postoperative movement was an advancement of 0.4 mm for the single-piece group and a relapse of 0.2 mm (3%) for the segmental group. The mean dental vertical relapse was 0.1 mm (4%) for the single-piece group and 0.3 mm (11%) for the segmental group. There was no statistically significant difference in relapse between the single-piece and segmental groups for all movements (P>.05).
  
  
  CONCLUSIONS
  Skeletal and dental relapse was similar between single-piece and segmental maxillary advancements using conventional Le Fort I orthognathic surgery in patients with UCLP.
authors.affiliation: Clinical Fellow in Craniofacial Surgery, The Centre for Craniofacial Care and Research, Division of Plastic Surgery, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada. Electronic address: drguywatts@gmail.com.
authors.forename: Guy D
authors.initials: GD
authors.lastname: Watts
authors.affiliation: Clinical Fellow in Craniofacial Orthodontics, Division of Orthodontics, Department of Dentistry, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Gregory S
authors.initials: GS
authors.lastname: Antonarakis
authors.affiliation: Professor, Head, and Craniofacial Surgeon, The Centre for Craniofacial Care and Research, Division of Plastic Surgery, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Forrest
authors.affiliation: Associate Professor, Head, and Orthodontist, Division of Orthodontics, Department of Dentistry, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Bryan D
authors.initials: BD
authors.lastname: Tompson
authors.affiliation: Associate Professor and Craniofacial Surgeon, The Centre for Craniofacial Care and Research, Division of Plastic Surgery, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
authors.forename: John H
authors.initials: JH
authors.lastname: Phillips
mesh_terms: D002971:Cleft Lip / Q000150:complications / Q000601:surgery*; D002972:Cleft Palate / Q000150:complications / Q000601:surgery*; D006801:Humans; D008310:Malocclusion / Q000150:complications / Q000601:surgery*; D008437:Maxilla / Q000601:surgery*; D010027:Osteotomy / Q000379:methods*; D012189:Retrospective Studies