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Management of Maxillary Deformities in Growing Cleft Patients

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Abstract

The maxillary deformities in growing cleft patients could be a hypoplastic maxilla, downward and/or laterally displaced premaxilla in bilateral clefts, wide alveolar cleft and fistula, or combinations of the above deformities. It is a challenge for both orthodontist and surgeon to treat a hypoplastic maxilla with wide alveolar cleft in a growing unilateral or bilateral cleft patient or a downward or laterally displaced premaxilla with wide alveolar cleft and fistula in a growing bilateral cleft patient.

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References

  • Akkaya S, Lorenzon S, Ucem TT (1999) A comparison of sagittal and vertical effects between bonded rapid and slow maxillary expansion procedures. Eur J Orthod 21:175–180

    Article  PubMed  CAS  Google Scholar 

  • Alcan T, Keles A, Erverdi N (2000) The effects of a modified protraction headgear on maxilla. Am J Orthod Dentofacial Orthop 117:27–38

    Article  PubMed  CAS  Google Scholar 

  • Bardach J, Morris HL, Olin WH, Gray SD, Jones DL, Kelly KM, Shaw WC, Semb G (1992) Results of multidisciplinary management of bilateral cleft lip and palate at Iowa cleft center. Plast Reconstr Surg 89:419–435

    Article  PubMed  CAS  Google Scholar 

  • Biederman W, Chem B (1973) Rapid correction of Class III malocclusion by midpalatal expansion. Am J Orthod 63:47–55

    Article  PubMed  CAS  Google Scholar 

  • Boyne PJ (1974) Use of marrow-cancellous bone grafts in maxillary alveolar and palatal clefts. J Dent Res 53:821–824

    Article  PubMed  CAS  Google Scholar 

  • Braun S, Bottrel JA, Lee KG, Lunazzi JJ, Legan HL (2000) The biomechanics of rapid maxillary sutural expansion. Am J Orthod Dentofacial Orthop 118:257–261

    Article  PubMed  CAS  Google Scholar 

  • Castello JR, Olaso AS, Chao JJ, McCarthy JG, Molina F (2000) Craniofacial shortening by contraction osteogenesis: an experimental model. Plast Reconstr Surg 105:617–625

    Article  PubMed  CAS  Google Scholar 

  • Chaconas SJ, Caputo AA (1982) Observation of orthopedic force distribution produced by maxillary orthodontic appliances. Am J Orthod 82(6):492–501

    Article  PubMed  CAS  Google Scholar 

  • Cozza P, Giancotti A, Petrosino A (2001) Rapid palatal expansion in mixed dentition using a modified expander: a cephalometric investigation. J Orthod 28:129–134

    Article  PubMed  CAS  Google Scholar 

  • Da Silva Filho OG, Boas MC, Capelozza Filho L (1991) Rapid maxillary expansion in the primary and mixed dentitions: a cephalometric evaluation. Am J Orthod Dentofacial Orthop 100:171–179

    Article  PubMed  Google Scholar 

  • Franchi L, Baccetti T, McNamara JA Jr (2000) Mandibular growth as related to cervical vertebral maturation and body height. Am J Orthod Dentofacial Orthop 118:335–340

    Article  PubMed  CAS  Google Scholar 

  • Freihofer HPM, Van Damme PHA, Kuijpers-Jagtman AM (1991) Early secondary osteotomy stabilization of premaxilla in bilateral clefts. J Craniomaxillofac Surg 19:2–6

    Article  PubMed  CAS  Google Scholar 

  • Friede H, Pruzansky S (1972) Longitudinal study of growth in bilateral cleft lip and palate from infancy to adolescence. Plast Reconstr Surg 49:392–403

    Article  PubMed  CAS  Google Scholar 

  • Friede H, Pruzansky S (1985) Long-term effects of premaxillary setback on facial skeletal profile in complete bilateral cleft lip and palate. Cleft Palate J 22:97–105

    PubMed  CAS  Google Scholar 

  • Haas AJ (1961) Rapid expansion of the maxillary dental arch and nasal cavity by opening the midpalatal suture. Angle Orthod 31:73–90

    Google Scholar 

  • Haas AJ (1965) Treatment of maxillary deficiency by opening the midpalatal suture. Angle Orthod 35:200–217

    PubMed  CAS  Google Scholar 

  • Haas AJ (1970) Palatal expansion: just the beginning of dentofacial orthopedics. Am J Orthod 57:219–255

    Article  PubMed  CAS  Google Scholar 

  • Haas AJ (1980) Long-term posttreatment evaluation of rapid palatal expansion. Angle Orthod 50:189–217

    PubMed  CAS  Google Scholar 

  • Haas AJ (2000) The nonsurgical treatment of the skeletal Class III. Book of abstract, American Association of Orthodontists 100th annual session, p 85

    Google Scholar 

  • Harvold EP (1961) Cephalometric roentgenography in the study of cleft lip and palate. In: Pruzansky S (ed) Congenital anomalies of the face and associated structures. Charles C. Thomas, Springfield, pp 329–336

    Google Scholar 

  • Hayward JR (1983) Management of the premaxilla in bilateral clefts. J Oral Maxillofac Surg 41:518–524

    Article  PubMed  CAS  Google Scholar 

  • Heidbuchel K, Kuijpers-Jagtman AM, Freihofer HPM (1993) An orthodontic and cephalometric study on the results of the combined approach of the protruded premaxilla in bilateral clefts. J Craniomaxillofac Surg 21:60–66

    Article  PubMed  CAS  Google Scholar 

  • Iino M, Sasaki T, Kochi S, Fukuda M, Takahashi T, Yamaguchi T (1998) Surgical repositioning of the premaxilla in combination with two-stage alveolar bone grafting in bilateral cleft lip and palate. Cleft Palate Craniofac J 35:304–309

    Article  PubMed  CAS  Google Scholar 

  • Itoh T (1985) Photoelastic effect of maxillary protraction on the craniofacial complex. Am J Orthod 88:117–124

    Article  PubMed  CAS  Google Scholar 

  • Jackson IT (1972) Closure of secondary palatal fistula with intraoral tissue and bone grafting. Br J Plast Surg 25:93–105

    Article  PubMed  CAS  Google Scholar 

  • Kawakami T, Nishimoto M, Matsuda Y, Deguchi T, Eda S (1996) Histological suture changes following retraction of the maxillary anterior bone segment after corticotomy. Endod Dent Traumatol 12:38–43

    Article  PubMed  CAS  Google Scholar 

  • Kawakami M, Yagi T, Takada K (2002) Maxillary expansion and protraction in correction of midface retrusion in a complete unilateral cleft lip and palate patient. Angle Orthod 72:355–361

    PubMed  Google Scholar 

  • Lee KG, Ryu YK, Park YC, Rudolph DJ (1997) A study of holographic interferometry on the initial reaction of maxillofacial complex during protraction. Am J Orthod Dentofacial Orthop 111:623–632

    Article  PubMed  CAS  Google Scholar 

  • Levrini L, Filippi V (1999) A fan-shaped maxillary expander. J Clin Orthod 33(11):642–643

    PubMed  CAS  Google Scholar 

  • Lin JCY, Liou EJW (2003) A new bone screw for orthodontic anchorage. J Clin Orthod 37:676–681

    PubMed  Google Scholar 

  • Liou EJW, Chen PKT (2003) New orthodontic and orthopedic managements on the premaxillary deformities in patients with bilateral cleft before alveolar bone grafting. Ann Coll Surg HK 7:73–82

    Article  Google Scholar 

  • Liou EJW, Tsai WC (2005) A new protocol for maxillary protraction in cleft patients: repetitive weekly protocol of alternate rapid maxillary expansions and constrictions. Cleft Palate Craniofac J 42:121–127

    Article  PubMed  Google Scholar 

  • Liou EJ, Chen KT, Chen RY, Huang CS (2000) Interdental distraction osteogenesis and rapid orthodontic tooth movement: a novel approach to approximate wide alveolar cleft or bony defect. Plast Reconstr Surg 105:1262–1272

    PubMed  CAS  Google Scholar 

  • Liou EJW, Chen PKT, Huang CS, Chen YR (2004) Orthopedic intrusion of premaxilla with distraction device before alveolar bone grafting in patients with bilateral cleft lip and palate. Plast Reconstr Surg 113:818–826

    Article  PubMed  Google Scholar 

  • Liu C, Song R, Song Y (2000) Sutural expansion osteogenesis for management of the bony-tissue defect in cleft palate repair: experimental studies in dogs. Plast Reconstr Surg 105:2012–2025

    Article  PubMed  CAS  Google Scholar 

  • McNamara JA Jr (1987) An orthopedic approach to the treatment of Class III malocclusion in young patients. J Clin Orthod 21:598–608

    PubMed  Google Scholar 

  • Mito T, Sato K, Mitani H (2003) Predicting mandibular growth potential with cervical vertebral bone age. Am J Orthod Dentofacial Orthop 124:173–177

    Article  PubMed  Google Scholar 

  • Nanda R, Sugawara J, Topazian RG (1983) Effect of maxillary osteotomy on subsequent craniofacial growth in adolescent monkeys. Am J Orthod 83:391–407

    Article  PubMed  CAS  Google Scholar 

  • Narula JD, Ross RB (1970) Facial growth in children with complete bilateral cleft lip and palate. Cleft Palate J 7:239–248

    PubMed  CAS  Google Scholar 

  • Pangrazio-Kulbersh V, Berger J, Kersten G (1998) Effects of protration mechanics on the midface. Am J Orthod Dentofacial Orthop 114:484–491

    Article  PubMed  CAS  Google Scholar 

  • Posnick JC, Tompson B (1995) Cleft-orthognathic surgery: complications and long-term results. Plast Reconstr Surg 96:255–266

    Article  PubMed  CAS  Google Scholar 

  • Pruzansky S (1955) Factors determining arch form in cleft of the lip and palate. Am J Orthod 41:827–851

    Article  Google Scholar 

  • Sarver DM, Johnston MW (1989) Skeletal changes in vertical and anterior displacement of the maxilla with bonded rapid palatal expansion appliances. Am J Orthod Dentofacial Orthop 95:462–466

    Article  PubMed  CAS  Google Scholar 

  • Smahel Z (1984) Craniofacial morphology in adults with bilateral complete cleft lip and palate. Cleft Palate J 21:159–169

    PubMed  CAS  Google Scholar 

  • Suzuki A, Takahama Y (1989) A jointed fan-type expander: a newly designed expansion appliance for the upper dental arch of patients with cleft lip and/or palate. Cleft Palate J 26(3):239–241

    PubMed  CAS  Google Scholar 

  • Tindlund RS (1994) Skeletal response to maxillary protraction in patients with cleft lip and palate before age 10 years. Cleft Palate Craniofac J 31:295–308

    Article  PubMed  CAS  Google Scholar 

  • Tindlund RS, Rygh P (1993) Soft-tissue profile changes during widening and protraction of the maxilla in patients with cleft lip and palate compared with normal growth and development. Cleft Palate Craniofac J 30:454–468

    Article  PubMed  CAS  Google Scholar 

  • Trotman CA, Ross RB (1993) Craniofacial growth in bilateral cleft lip and palate: ages six years to adulthood. Cleft Palate Craniofac J 30:261–273

    Article  PubMed  CAS  Google Scholar 

  • Turley PK (1988) Orthopedic correction of Class III malocclusion with palatal expansion and custom protraction headgear. J Clin Orthod 22:314–325

    PubMed  CAS  Google Scholar 

  • Vardimon AD, Brosh T, Spiegler A, Lieberman M, Pitaru S (1998) Rapid palatal expansion: part 1. Mineralization pattern of the midpalatal suture in cats. Am J Orthod Dentofacial Orthop 113:371–378

    PubMed  CAS  Google Scholar 

  • Vargervik K (1983) Growth characteristics of the premaxilla and orthodontic treatment principles in bilateral cleft lip and palate. Cleft Palate J 20:289–302

    PubMed  CAS  Google Scholar 

  • Wertz RA (1970) Skeletal and dental changes accompanying rapid midpalatal suture opening. Am J Orthod 58:41–66

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Eric J. W. Liou DDS, MS .

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Liou, E.J.W., Chen, P.K.T. (2013). Management of Maxillary Deformities in Growing Cleft Patients. In: Berkowitz, S. (eds) Cleft Lip and Palate. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-30770-6_30

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  • DOI: https://doi.org/10.1007/978-3-642-30770-6_30

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