Occlusal and Cephalometric Outcomes of Cleft Orthognathic Surgery: A Retrospective Cohort Study

IF 1.7 Q3 DENTISTRY, ORAL SURGERY & MEDICINE Clinical and Experimental Dental Research Pub Date : 2024-11-04 DOI:10.1002/cre2.70019

Daniel Stonehouse-Smith, Aida N.A. Abd Rahman, Victoria Beale, Haydn Bellardie

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Abstract

Objectives

Aberrant facial growth in individuals affected by orofacial clefts can result in maxillary retrusion and class III malocclusion, with a proportion requiring surgical correction at cessation of growth. This study aimed to evaluate occlusal and cephalometric outcomes of combined orthodontic-orthognathic treatment.

Material and Methods

Retrospective cohort study in a United Kingdom cleft center. Participants included twenty-seven patients (20 males, 7 females) with cleft (n = 16 UCLP :7 BCLP :4 ICP) who consecutively underwent combined surgical treatment for Class III malocclusion between January 2013 and December 2017. Records were collected pre-treatment (T0), pre-surgery (T1) and at debond (T2). Models were scored using the Peer Assessment Rating (PAR) index and cephalometric radiographs were traced and analyzed. Outcomes were assessed by an independent rater.

Results

Mean age at surgery was 21.4 years (SD 4.9). Le Fort 1 advancement (mean 6.1 mm, SD 4.0) was performed in all cases. Additional procedures included mandibular setback (n = 2), cortico-cancellous bone grafting (n = 6) and genioplasty (n = 1). Mean T0 PAR score was 44.8 (SD 11.7), reducing to 3.6 (SD 2.0) at T2, indicating a mean % PAR score reduction of 91.6% (SD 4.7). Class III skeletal profiles improved from a mean T0 ANB of −2.1º (SD 2.2), to 2.8º (SD 1.6) at T2. Mean T0 overjet was −3.3 mm (SD 2.3), increasing to 2.6 mm (SD 1.3) at T2.

Conclusion

Cleft orthognathic surgery differs in complexity and approach to routine orthognathics, however, these results demonstrate that occlusal outcomes can still be comparable with non-cleft populations. Outcome data can be used for comparison with other centers providing cleft orthognathic treatment.

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唇裂正颌手术的咬合和头颅测量结果：回顾性队列研究

目的：口面裂患者面部发育异常可导致上颌后缩和III度错颌畸形，其中一部分患者在停止发育时需要进行手术矫正。本研究旨在评估正畸-正颌联合治疗的咬合和头型测量结果：在英国一家裂隙中心进行的回顾性队列研究。参与者包括二十七名患者（20 名男性，7 名女性），他们都是在 2013 年 1 月至 2017 年 12 月期间连续接受了 III 类错牙合畸形联合手术治疗的唇裂患者（n = 16 UCLP :7 BCLP :4 ICP）。收集了治疗前（T0）、手术前（T1）和脱颌时（T2）的记录。使用同行评估等级（PAR）指数对模型进行评分，并对头颅X光片进行追踪和分析。结果由一名独立评分员进行评估：手术时的平均年龄为 21.4 岁（标清 4.9）。所有病例都进行了 Le Fort 1 前移（平均 6.1 毫米，标准差 4.0）。其他手术包括下颌后移（2 例）、皮质冠状骨移植（6 例）和咬肌成形术（1 例）。T0的平均PAR评分为44.8（标准差11.7），T2时降至3.6（标准差2.0），表明平均PAR评分降低了91.6%（标准差4.7）。III 类骨骼轮廓的平均 T0 ANB 从 -2.1º (SD 2.2) 下降到 T2 时的 2.8º (SD 1.6)。T0过咬合平均值为-3.3毫米（标准差2.3），T2时增加到2.6毫米（标准差1.3）：结论：裂隙正颌手术的复杂程度和方法与常规正颌手术不同，但这些结果表明，咬合结果仍可与非裂隙人群进行比较。结果数据可用于与其他提供唇裂正颌治疗的中心进行比较。

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来源期刊

Clinical and Experimental Dental Research DENTISTRY, ORAL SURGERY & MEDICINE-

CiteScore

3.30

自引率

5.60%

发文量

165

审稿时长

26 weeks

期刊介绍： Clinical and Experimental Dental Research aims to provide open access peer-reviewed publications of high scientific quality representing original clinical, diagnostic or experimental work within all disciplines and fields of oral medicine and dentistry. The scope of Clinical and Experimental Dental Research comprises original research material on the anatomy, physiology and pathology of oro-facial, oro-pharyngeal and maxillofacial tissues, and functions and dysfunctions within the stomatognathic system, and the epidemiology, aetiology, prevention, diagnosis, prognosis and therapy of diseases and conditions that have an effect on the homeostasis of the mouth, jaws, and closely associated structures, as well as the healing and regeneration and the clinical aspects of replacement of hard and soft tissues with biomaterials, and the rehabilitation of stomatognathic functions. Studies that bring new knowledge on how to advance health on the individual or public health levels, including interactions between oral and general health and ill-health are welcome.