Chang Hao-Hsiang, Chen Yun-Fang, Lu Ting-Chen, Chang Chun-Shin, Ruschasetkul Sutthinee, Liao Yu-Fang
Graduate Institute of Dental and Craniofacial Science, Chang Gung University, Taoyuan, Taiwan.
Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, Taipei, Taiwan.
Clin Oral Investig. 2024 May 22;28(6):331. doi: 10.1007/s00784-024-05704-4.
Segmental Le Fort I osteotomy through the cleft is a common strategy to narrow the alveolar cleft in adults. This study compared skeletal stability between single and segmental Le Fort I osteotomies in patients with unilateral cleft lip and palate (UCLP).
This retrospective analysis examined 45 adults with complete UCLP-associated class III deformities who underwent bimaxillary surgery with either single (n = 30) or segmental (n = 15) Le Fort I advancement. Cone beam computed tomography (CBCT) scans of the facial skeleton were acquired before surgery, 1-week postsurgery, and at follow-up. Measures of landmarks from the CBCT images for the two treatment groups were compared for translation (left/right, posterior/anterior, superior/inferior) and rotation (yaw, roll, pitch).
Postsurgery, the downward movement of the maxilla was larger in the segmental group than the single group. At follow-up, the maxilla moved backward in both groups, and upward in the segmental group. The mandible moved forward and upward and rotated upward in both groups. The amount of upward movement and rotation was larger in the segmental group than the single group.
Two years after bimaxillary surgery in patients with UCLP-associated class III deformity, greater relapse was found after segmental Le Fort I osteotomies in vertical translation of the maxilla and mandible, and pitch rotation of the mandible compared with single Le Fort I osteotomies.
The vertical relapse of the maxilla was larger after segmental Le Fort I advancement compared with single Le Fort I advancement in clefts.
通过裂隙进行节段性Le Fort I截骨术是成人中缩小牙槽裂的常用策略。本研究比较了单侧唇腭裂（UCLP）患者单节段和节段性Le Fort I截骨术后的骨骼稳定性。
本回顾性分析研究了45例患有完全性UCLP相关III类畸形的成人患者，这些患者接受了单节段（n = 30）或节段性（n = 15）Le Fort I前徙的双颌手术。在手术前、术后1周和随访时获取面部骨骼的锥形束计算机断层扫描（CBCT）图像。比较两个治疗组CBCT图像上标志点在平移（左/右、后/前、上/下）和旋转（偏航、翻滚、俯仰）方面的测量值。
术后，节段性组上颌骨向下移动比单节段组更大。随访时，两组上颌骨均向后移动，节段性组向上移动。两组下颌骨均向前和向上移动并向上旋转。节段性组向上移动和旋转的量比单节段组更大。
在患有UCLP相关III类畸形的患者进行双颌手术后两年，与单节段Le Fort I截骨术相比，节段性Le Fort I截骨术后上颌骨和下颌骨的垂直平移以及下颌骨的俯仰旋转出现了更大程度的复发。
在腭裂患者中，与单节段Le Fort I前徙相比，节段性Le Fort I前徙后上颌骨的垂直复发更大。
