RESUMEN
Patients with unilateral cleft lip and palate (UCLP) can present with an asymmetric transversal deficiency caused by collapse of the lateral maxillary segment at the cleft side. The surgical technique and orthodontic implications of segmental unilateral transpalatal distraction (TPD) after a posterior maxillary subapical osteotomy using the transpalatal distractor (TPD(R)) are described. The differences between unilateral posterior surgical-assisted rapid palatal expansion (SA-RPE) and segmental unilateral TPD are discussed. The proposed orthodontic-surgical treatment strategy certainly has to be validated by long-term studies in the future.
Asunto(s)
Fisura del Paladar/cirugía , Procedimientos Quirúrgicos Orales/métodos , Osteogénesis por Distracción/métodos , Técnica de Expansión Palatina/instrumentación , Labio Leporino/cirugía , Humanos , Osteogénesis por Distracción/instrumentación , Hueso Paladar/cirugíaRESUMEN
PATIENTS AND METHODS: The craniofacial morphology of 10-year-old male (n = 23) and female (n = 13) patients with unilateral cleft lip and palate was evaluated by means of cephalometric analysis. The control group comprised 40 non-orthodontically treated non-cleft patients from the same population (20 boys, 20 girls) with neutroclusion, matched according to age and gender. Furthermore the results of the cephalometric analysis were compared with those of other cleft centers. Primary rehabilitation of all patients was performed according to a uniform concept at Hanover Medical School. All cephalometric radiographs were analyzed according to Ross [26]. This analysis permitted comparison with the results of two different cleft centers covering 107 patients, published by Ross. RESULTS: In comparison with the control group, both boys and girls with unilateral cleft lip and palate showed a significant retrusion and clockwise rotation of the mandible as well as a decreased vertical midfacial development.