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

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dc.contributor.authorFarina, Rodrigo
dc.contributor.authorLolas, Jorge
dc.contributor.authorMoreno, Emilio
dc.contributor.authorAlister, Juan Pablo
dc.contributor.authorUribe, Maria Francisca
dc.contributor.authorPantoja, Roberto
dc.contributor.authorValladares, Salvador
dc.contributor.authorArrue, Camila
dc.date.accessioned2025-01-20T21:12:01Z
dc.date.available2025-01-20T21:12:01Z
dc.date.issued2022
dc.description.abstractA 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.
dc.fuente.origenWOS
dc.identifier.doi10.1097/SCS.0000000000007973
dc.identifier.eissn1536-3732
dc.identifier.issn1049-2275
dc.identifier.urihttps://doi.org/10.1097/SCS.0000000000007973
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/93640
dc.identifier.wosidWOS:000762006200073
dc.issue.numero2
dc.language.isoen
dc.pagina.final501
dc.pagina.inicio496
dc.revistaJournal of craniofacial surgery
dc.rightsacceso restringido
dc.subjectCleft lip and palate
dc.subjectdentofacial abnormalities
dc.subjectdentofacial deformity
dc.subjectdistraction osteogenesis
dc.subjectmaxillary hypoplasia
dc.subjectmaxillary osteotomy
dc.subjectmidfacial advancement
dc.subjectmidfacial hypoplasia
dc.subjectorthognathic surgery
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleCleft Lip and Palate Midfacial Hypoplasia: Criteria to Choose the Treatment
dc.typeartículo
dc.volumen33
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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