Surgical-Orthodontic Treatment in Patients with Cleft Lip and Palate: Conventional Surgery Versus Maxillary Distraction Osteogenesis

Abstract

Aim: To compare two cleft lip and palate patients treated with conventional surgery to one treated with maxillary distraction osteogenesis. Methods: To correct the transverse problems in a patient with cleft lip and palate and a constricted maxilla, two-piece surgery via Le Fort I osteotomy was performed along with bimaxillary surgery. In twin sisters, maxillary advancement via distraction osteogenesis was performed on the older, while the younger sister was treated with bimaxillary surgery. Results: Acceptable results were achieved in the patient treated with two-jaw surgery, despite the large mandibular setback. In the twins, the older sister, who had an underdeveloped maxilla, showed good results through maxillary distraction osteogenesis. The treatment results for the younger sister were less satisfying because of the greater amount of mandibular setback, which was due to the limited amount of maxillary advancement. Conclusion: Patients with cleft lip and palate can be successfully treated through conventional surgery and orthodontic treatment, but maxillary distraction osteogenesis is also a valuable treatment option for patients with cleft lip and palate and limited maxillary advancement.