Mandibular effects of maxillary distraction osteogenesis in cleft lip and palate

详细信息    查看全文

• 作者：J.-C. Doucet¹ ; ² ; ^{jcdoucet@gmail.com" class="auth_mail} ; C. Herlin¹ ; M. Bigorre¹ ; C. Bä ; umler¹ ; G. Subsol³ ; G. Captier ; ¹ ; ⁴ ; ^{g-captier@chu-montpellier.fr" class="auth_mail}
• 关键词：cleft palate ; cleft lip ; growth ; distraction ; mandible ; maxilla
• 刊名：International Journal of Oral and Maxillofacial Surgery
• 出版年：June 2014
• 年：2014
• 卷：43
• 期：6
• 页码：702-707
• 全文大小：863 K

文摘

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.