Centre for Craniofacial & Regenerative Biology, King's College London, London, UK.
Faculty of Dentistry, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia.
Clin Exp Dent Res. 2024 Dec;10(6):e70019. doi: 10.1002/cre2.70019.
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.
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.
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.
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.
患有口面裂的个体的面部生长异常可导致上颌后缩和 III 类错颌，其中一部分需要在生长停止后进行手术矫正。本研究旨在评估正畸-正颌联合治疗的咬合和头颅测量学结果。
英国裂腭中心的回顾性队列研究。参与者包括 27 名患者（20 名男性，7 名女性），其中 16 名患有单侧唇裂腭裂（UCLP），7 名患有双侧唇裂腭裂（BCLP），4 名患有正中腭裂（ICP），他们在 2013 年 1 月至 2017 年 12 月期间连续接受 III 类错颌的联合手术治疗。记录在治疗前（T0）、术前（T1）和去带环时（T2）采集。模型使用同伴评估评分（PAR）指数进行评分，头颅侧位片进行描记和分析。结果由独立评估者进行评估。
手术时的平均年龄为 21.4 岁（SD 4.9）。所有病例均行 Le Fort 1 前徙术（平均 6.1mm，SD 4.0）。其他手术包括下颌后退术（n=2）、皮质骨松质骨移植术（n=6）和颏成形术（n=1）。T0 时的平均 PAR 评分为 44.8（SD 11.7），T2 时降至 3.6（SD 2.0），表明平均 PAR 评分降低 91.6%（SD 4.7）。III 类骨骼侧貌从 T0 的平均 ANB -2.1°（SD 2.2）改善至 T2 的 2.8°（SD 1.6）。T0 时的平均覆颌为-3.3mm（SD 2.3），T2 时增加至 2.6mm（SD 1.3）。
裂腭正颌手术的复杂性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腭人群相媲美。结果数据可用于与提供裂腭正颌治疗的其他中心进行比较。
