Cleft Lip and Palate Midfacial Hypoplasia: Criteria to Choose the Treatment

Primer Autor
Farina, Rodrigo
Co-autores
Lolas, Jorge
Moreno, Emilio
Alister, Juan Pablo
Uribe, Maria Francisca
Pantoja, Roberto
Valladares, Salvador
Arrue, Camila
Título
Cleft Lip and Palate Midfacial Hypoplasia: Criteria to Choose the Treatment
Editorial
LIPPINCOTT WILLIAMS & WILKINS
Revista
JOURNAL OF CRANIOFACIAL SURGERY
Lenguaje
en
Resumen
A series of skeletal and dentoalveolar/occlusal criteria were proposed for choosing the treatment modality for the management of midface hypoplasia in cleft lip/palate patients, focusing on functional improvement, aesthetics, and minimizing the risk of recurrence and secondary alterations. For which, 42 patients with nonsyndromic cleft lip/palate, all with previous primary lip/palate surgeries and without previous osteotomies, were analyzed. Orthognathic surgery (OS) (n = 24) and maxillary distraction osteogenesis (n = 18) with anterior segmental osteotomies (segmental distraction osteogenesis [SD]), alveolar transport disc (TD), and midface total distraction osteogenesis (TDO) by modified Le Fort III osteotomy was done. The average of maxillary advancement for OS was 5.58 +/- 0.83 mm, for SD 9.4 +/- 0.89 mm, for TD 8.00 +/- 1.00 mm, and for TDO was 8.13 +/- 1.55 mm. In the presence of infraorbital and/or zygomatic hypoplasia, TDO was performed using skeletal anchorage, with the requirement of occlusal stability in dental cast in occlusion. In short maxillary arch without dental cast feasibility in occlusion, hypodontia/agenesis or absence of premaxilla, TD and SD was performed. There was only 1 mm of recurrence in 1 patient of each group. Changes in speech were detected in 2 patients in the OS group (8.3%). Orthognathic surgery can be indicated for advancements <= 7 mm not requiring orbito-zygomatic advancement, whereas distraction osteogenesis can be indicated for advances >8 mm with or without the need for orbito-zygomatic advancement, in addition with other dentoalveolar factors and velopharyngeal function.
Tipo de Recurso
artículo original
doi
10.1097/SCS.0000000000007973
Formato Recurso
PDF
Palabras Claves
Cleft lip and palate
dentofacial abnormalities
dentofacial deformity
distraction osteogenesis
maxillary hypoplasia
maxillary osteotomy
midfacial advancement
midfacial hypoplasia
orthognathic surgery
TERM SKELETAL STABILITY
DISTRACTION OSTEOGENESIS
MAXILLARY ADVANCEMENT
ORTHOGNATHIC SURGERY
FACIAL GROWTH
MORPHOLOGY
INDIVIDUALS
MANAGEMENT
OSTEOTOMY
MOVEMENT
Ubicación del archivo
http://dx.doi.org/10.1097/SCS.0000000000007973
Categoría OCDE
Cirugía
Materias
labio y paladar hendido
anomalías dentofaciales
deformidad dentofacial
osteogénesis por distracción
hipoplasia maxilar
osteotomía maxilar
avance mediofacial
hipoplasia mediofacial
cirugía ortognática
TERMINO ESTABILIDAD ESQUELÉTICA
OSTEOGÉNESIS DISTRACCIÓN
AVANCE MAXILAR
CIRUGÍA ORTOGNÁTICA
CRECIMIENTO FACIAL
MORFOLOGÍA
INDIVIDUAL
MANEJO
OSTEOTOMÍA
MOVIMIENTO
Título de la cita (Recomendado-único)
Cleft Lip and Palate Midfacial Hypoplasia: Criteria to Choose the Treatment
Página de inicio (Recomendado-único)
496
Página final (Recomendado-único)
501
Identificador del recurso (Mandatado-único)
artículo original
Versión del recurso (Recomendado-único)
version publicada
Condición de la licencia (Recomendado-repetible)
0
Derechos de acceso
metadata
Access Rights
metadata
Id de Web of Science
WOS:000762006200073
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