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. 2021 Aug 13:2021:4572397.
doi: 10.1155/2021/4572397. eCollection 2021.

Three-Dimensional Outcome Assessments of Surgical Correction in Cleft and Noncleft Patients with Class III Skeletal Relation: A Case-Control Study

Te-Ju Wu  1 , Cheng-Chun Wu  2 , Chi-Yu Tsai  1 , Yi-Hao Lee  1 , Yu-Jen Chang  1 , Shiu-Shiung Lin  1 , Jui-Pin Lai  2
Affiliations

Three-Dimensional Outcome Assessments of Surgical Correction in Cleft and Noncleft Patients with Class III Skeletal Relation: A Case-Control Study

Te-Ju Wu et al. Biomed Res Int. .

Abstract

Background: The orthognathic strategies to treat patients with a concave profile but different tissue conditions remain controversial. The aim of this case-control study was to investigate the outcome predictability of orthognathic surgery in cleft lip and palate (CLP) patients and matched controls.

Methods: Fifty consecutive CLP and 45 matched non-CLP patients who received whole-piece Le Fort I and bilateral sagittal split osteotomy to correct class III skeletal relations were enrolled. The outcome discrepancies (ODs) from simulations among all groups were evaluated with consideration of the possible influences from planned surgical movements (PSM). Receiver operating characteristic curves were used to determine threshold values of PSMs that yielded clinically relevant OD.

Results: Unilateral CLP (UCLP) patients had comparable postsurgical OD to non-CLP patients in both jaws, whereas bilateral CLP (BCLP) patients had greater deviations from predicted results. Vertical movement of the A - point > 1.33 mm and yaw correction > 1.65° in the BCLP patients was associated with clinically relevant maxillary OD.

Conclusions: The OGS outcomes of BCLP patients were less predictable than those of the UCLP and noncleft patients. Vertical movements of the A - point > 1.33 mm and yaw correction > 1.65° in BCLP patients increased OD to a clinically relevant extent.

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Conflict of interest statement

All the authors in this study claimed no interests and conflicts related to this research.

Figures

Figure 1
Figure 1
(a) Reverse engineering was applied to fabricate the surgical guide. A stereolithographic model demonstrating the planned maxillary reposition was produced. The fixation miniplates serving as the guiding plate (the 2nd guiding plate) were prebent according to the plate holes marked on the model. (b) Anterior nasal spine (ANS) and infrazygomatic crest (IZC) were used as reference structures for designing the guiding plate on the presurgical virtual maxilla. (c, d) The mandibular guiding plates were also fabricated according to the final position of MMC to provide predicted amounts of the movements of the mandibular segments intraoperatively.
Figure 2
Figure 2
The virtual triangles representing orientation of the maxilla in different stages (yellow: simulation, blue: 6-month outcome) were used for the outcome assessments. All the three-dimensional images were registered on the same coordination system.
See this image and copyright information in PMC

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