title: [Maxillary advancement osteotomy with sequelae cleft lip and palate: Dilemma between occlusion and aesthetic profile].
abstract: BACKGROUND
  Maxillary hypoplasia is a common sequela of cleft lip and palate. Its surgical treatment consists in a maxillary advancement by distraction or by conventional orthognathic surgery but morphological results are unpredictable. Our goal in this study was to see if the esthetical results (on the lip and the nose) of maxillary advancement were correlated to the preservation of lateral incisor space of the cleft side.
  
  
  METHODS
  This retrospective study included 38 patients operated between 2002 and 2013. Unilateral clefts were studied independently from bilateral clefts. Profile aesthetics was evaluated independently and subjectively by two surgeons and scored on an 8-point scale. The result was classified as "good" if the score was superior or equal to 6. The score was correlated to the following parameters: amount of maxillary advancement, upper incisor axis, preservation of the missing lateral incisor space.
  
  
  RESULTS
  In the "good result" group, the space of the lateral incisor was less often preserved. The nasolabial angle was more open and the upper central incisor axis more vertical. These results were more pronounced in bilateral clefts, but also found in unilateral clefts.
  
  
  CONCLUSIONS
  Under reservation of the subjective evaluation and of the small number of patients, it seemed that lateral incisor space closure improved the profile of patients treated by maxillary advancement for cleft lip and palate sequelae.
authors.affiliation: Service de chirurgie plastique et maxillo-faciale, hôpital A.-Michallon, BP217, 38043 Grenoble cedex, France. Electronic address: avigneron@chu-grenoble.fr.
authors.forename: A
authors.initials: A
authors.lastname: Vigneron
authors.affiliation: Service de chirurgie plastique et maxillo-faciale, hôpital A.-Michallon, BP217, 38043 Grenoble cedex, France.
authors.forename: B
authors.initials: B
authors.lastname: Morand
authors.affiliation: Service de chirurgie plastique et maxillo-faciale, hôpital A.-Michallon, BP217, 38043 Grenoble cedex, France.
authors.forename: V
authors.initials: V
authors.lastname: Lafontaine
authors.affiliation: Service de chirurgie plastique et maxillo-faciale, hôpital A.-Michallon, BP217, 38043 Grenoble cedex, France.
authors.forename: V
authors.initials: V
authors.lastname: Lesne
authors.affiliation: Service de chirurgie plastique et maxillo-faciale, hôpital A.-Michallon, BP217, 38043 Grenoble cedex, France.
authors.forename: C
authors.initials: C
authors.lastname: Lesne
authors.affiliation: Service de chirurgie plastique et maxillo-faciale, hôpital A.-Michallon, BP217, 38043 Grenoble cedex, France.
authors.forename: G
authors.initials: G
authors.lastname: Bettega
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002971:Cleft Lip / Q000150:complications / Q000601:surgery*; D002972:Cleft Palate / Q000150:complications / Q000601:surgery*; D004954:Esthetics; D005260:Female; D006801:Humans; D008046:Lip / Q000601:surgery*; D008297:Male; D008310:Malocclusion / Q000150:complications / Q000601:surgery*; D008437:Maxilla / Q000601:surgery; D063166:Maxillary Osteotomy / Q000379:methods*; D009666:Nose / Q000601:surgery*; D056948:Orthognathic Surgical Procedures; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D055815:Young Adult
keywords: Chirurgie orthognathique; Cleft lip; Cleft palate; Fente labiale; Fente palatine; Le Fort osteotomy; Orthognathic surgery; Ostéotomie de Le Fort