Effects of bone anchored maxillary protraction on patients with unilateral cleft lip/palate or isolated cleft palate and hypoplastic maxilla: a 6-year follow-up case control study.

Anu Kiukkonen, David Rice, Sirpa Railavo
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Abstract

Objectives: To evaluate the effects of bone-anchored maxillary protraction (BAMP) treatment and longterm stability in growing cleft lip and palate and isolated cleft palate (CLP/CP) patients with mild maxillary hypoplasia and to compare maxillary growth patterns of BAMP-treated patients to matched control CLP/CP patients.

Materials and methods: Ten patients with CLP/CP were treated with BAMP; they were compared to the maxillary growth pattern of 10 age-matched cleft control patients with no maxillary protraction treatment, who later received surgical Le Fort I maxillary advancement after the growth period. The assessment of maxillary growth and the occlusion started at mean 8 years of age and continued until mean 18 years of age.

Results: The use of BAMP orthopedic traction changed the growth pattern of mild hypoplastic maxilla toward a more anterior direction and advanced the face even above the level of Le Fort lll with only a minor effect on dentoalveolar units. The correction of occlusion and facial convexity were stable in the long term.

Conclusions: The using BAMP may improve the position of the maxilla relative to the anterior cranial base for the correction of mild maxillary hypoplasia in adolescent patients with CLP/CP. The achieved results are rather stable in the long term.

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骨固定上颌骨牵引对单侧唇腭裂或孤立性腭裂和上颌骨发育不良患者的影响:一项为期 6 年的病例对照随访研究。
研究目的评估上颌骨轻度发育不良的唇腭裂和孤立性腭裂(CLP/CP)患者接受骨固定上颌骨牵引(BAMP)治疗的效果和长期稳定性,并将接受BAMP治疗的患者的上颌骨发育模式与匹配的对照组CLP/CP患者的上颌骨发育模式进行比较:10名CLP/CP患者接受了BAMP治疗,并与10名年龄匹配、未接受上颌前突治疗的裂隙对照组患者的上颌发育模式进行了比较。对上颌骨生长和咬合的评估从平均 8 岁开始,一直持续到平均 18 岁:结果:BAMP矫形牵引器的使用改变了轻度发育不良上颌骨的生长模式,使其向更前方的方向生长,并使面部前移,甚至超过了 Le Fort lll 的水平,但对牙槽单位仅有轻微影响。咬合和面部凸度的矫正效果长期稳定:结论:使用BAMP可以改善上颌骨相对于前颅基底的位置,从而矫正CLP/CP青少年患者的轻度上颌骨发育不良。所取得的效果长期来看相当稳定。
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