Skip to main content

Advertisement

SpringerLink
Log in

Cephalometric Analysis of Hard and Soft Tissue Changes Following Anterior Maxillary Osteotomy Distraction in Cleft Maxillary Hypoplasia

  • Original Article
  • Published:
Journal of Maxillofacial and Oral Surgery Aims and scope Submit manuscript

Abstract

Background

Nonsyndromic unilateral CLAP patients despite the best surgical efforts present with variable degree of maxillary hypoplasia after cleft palate repair. AMOD is an extension of anterior maxillary osteotomy where the resulting segment anterior to the chosen site of vertical corticotomy cut is distracted with the help of hyrax screw through a tooth-borne appliance.

Aims and Objectives

To analyze the hard and soft tissue profile changes following AMOD. To determine the ratio of soft tissue changes to the given extent of hard tissue movements.

Materials and Methods

Study group consisted of 25 patients with cleft maxillary hypoplasia reporting to the Department of OMFS, Coorg Institute of Dental Science. The preoperative and postoperative radiographs were taken followed by prediction tracing. In comparison of pre-op and post-op ceph mean improvement in hard tissue profile was seen at N-A by 2.84 mm, N-A-Pg by 2.52, ANS-Gn by 2.28 mm, N-ANS by 0.68 mm, 1-Nf by 0.32 and at PNS-ANS was 4.2 mm signifying improvement in middle third of face. Mean improvement in soft tissue profile at G-Sn-Pg angle by 1.2, G-Sn was 3.92 mm, nasolabial angle by 10.92, incisor exposure (Stm-1) by 0.24 mm and interlabial gap by 0.56 mm. On ratio and correlation of soft tissue changes to given extent of hard tissue change, with movement of point A and U1 resulted significant changes in Sn and Ls. Movement of ANS resulted in significant changes in pronasale and columella.

Conclusions

In our study significant improvement was seen in hard and soft tissue facial profile. In conclusion, AMOD is one of the emerging techniques to correct cleft maxillary hypoplasia which will have a defined definitive role to play in future.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10
Fig. 11
Fig. 12

Similar content being viewed by others

References

  1. Mansour S, Burstone C, Legan H (1983) An evaluation of soft-tissue changes resulting from Le Fort I maxillary surgery. Am J Orthod 84(1):37–47

    Article  CAS  Google Scholar 

  2. Ross RB (1987) Treatment variables affecting facial growth in complete unilateral cleft lip and palate. Part 1: treatment affecting growth. Cleft Palate J 24(1):5–23

    CAS  PubMed  Google Scholar 

  3. Cheung LK, Chua HD (2006) A meta-analysis of cleft maxillary osteotomy and distraction osteogenesis. Int J Oral Maxillofac Surg 35(1):14–24

    Article  CAS  Google Scholar 

  4. Cheung LK, Chua HD, Hägg MB (2006) Cleft maxillary distraction versus orthognathic surgery: clinical morbidities and surgical relapse. Plast Reconstr Surg 118(4):996–1008

    Article  CAS  Google Scholar 

  5. Wang XX, Wang X, Li ZL, Yi B, Liang C, Jia YL, Zou BS (2009) Anterior maxillary segmental distraction for correction of maxillary hypoplasia and dental crowding in cleft palate patients: a preliminary report. Int J Oral Maxillofac Surg 38(12):1237–1243

    Article  Google Scholar 

  6. Chua HD, Hägg MB, Cheung LK (2010) Cleft maxillary distraction versus orthognathic surgery–which one is more stable in 5 years? Oral Surg Oral Med Oral Pathol Oral Radiol Endod 109:803–814

    Article  Google Scholar 

  7. Markose E, Paulose J, Paul ET (2013) Soft tissue changes in cleft lip and palate patients: anterior maxillary distraction versus conventional Le-Fort I osteotomy. J Maxillofac Oral Surg 12(4):429–435

    Article  Google Scholar 

  8. Codivilla A (1905) On the means of lengthening, in the lower limbs, the muscles, and tissues are shortened through deformity. JBJS 2(4):353–369

    Google Scholar 

  9. Polley JW, Figueroa AA (1997) Management of severe maxillary deficiency in childhood and adolescence through distraction osteogenesis with an external, adjustable, rigid distraction device. J Craniofac Surg 8(3):181–185

    Article  CAS  Google Scholar 

  10. Rao S, Kotrashetti SM, Lingaraj JB, Pinto PX, Keluskar KM, Jain S, Sone P, Rao S (2013) Anterior segmental distraction osteogenesis in the hypoplastic cleft maxilla: report of five cases. Sultan Qaboos Univ Med J 13(3):454

    Article  Google Scholar 

  11. Bengi O, Karaçay Ş, Akin E, Okçu KM, Ölmez H, Mermut S (2007) Cephalometric evaluation of patients treated by maxillary anterior segmental distraction: a preliminary report. J Cranio-Maxillofac Surg 35(6):302–310

    Article  Google Scholar 

  12. Malik S, Singh V, Singh G, Anand SC. Role of Le fort I osteotomy in orthosurgical management of maxillary deformities in the north Indian population

Download references

Author information

Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, Sri Hasanamba Dental College and Hospital, Vidyanagar, Hassan, 573201, India

    Adarsh Lingeshbabu Pawar

  2. ABMSS/DCKH Cleft Centre, Indi, India

    Jayanth Basavapattana Shivasubramanya

  3. Kannur, India

    Shanavas Kolothu Parambil

  4. Department of Public Health Dentistry, Coorg Institute of Dental Science, Virajpet, Coorg, Karnataka, 571218, India

    Anand Shivamoga Raju

  5. Hitech Dental College, Bhubaneshwar, Odissa, 0674, India

    Abhitosh Debata

Authors
  1. Adarsh Lingeshbabu Pawar
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jayanth Basavapattana Shivasubramanya
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Shanavas Kolothu Parambil
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Anand Shivamoga Raju
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Abhitosh Debata
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Adarsh Lingeshbabu Pawar.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from the individual participant included in the case for the treatment as well consent was obtained for the photographs.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lingeshbabu Pawar, A., Basavapattana Shivasubramanya, J., Kolothu Parambil, S. et al. Cephalometric Analysis of Hard and Soft Tissue Changes Following Anterior Maxillary Osteotomy Distraction in Cleft Maxillary Hypoplasia. J. Maxillofac. Oral Surg. 20, 680–688 (2021). https://doi.org/10.1007/s12663-020-01404-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12663-020-01404-0

Keywords

Search

Navigation