Orthodontic surgery with alveolar cleft grafting in patients with complete unilateral cleft lip and palate：a feasibility analysis based on cone-beam CT three-dimensional reconstruction

Shen Yue; Ma Hai-ying; Zhang Yan-sheng; Wang Juan; Shi Bing-zheng

doi:10.3969/j.issn.2095-4344.2015.11.008

Abstract：BACKGROUND:Some cleft lip and palate patients at 9-10 years of age (the canine root development about 1/2-2/3) cannot achieve a good orthodontic outcome after bone grafting, and moreover, there is no unified therapeutic procedure for patients at 7-10 years of age before and after bone grafting. Cone-beam CT can reflect the fine structure accurately under the premise not to destroy normal tissue structure, and have access to the relevant measurement data by matched computer software. OBJECTIVE:To compare the therapeutic effect of orthodontic surgery combined with alveolar cleft bone grafting at different order for treatment of complete unilateral cleft lip and palate. METHODS: Sixty patients with complete unilateral cleft lip and palate admitted at Cangzhou People’s Hospital from 2012 to 2013 were enroled and divided into three groups with 20 in each group: group A, autologous iliac <br> graft was done folowed by 3 months of wearing orthodontic retainer; Group B, autologous iliac graft was done immediately after orthodontic treatment and then, orthodontic retainer was used for 3 consecutive months; group C, orthodontic retainer was used for 3 consecutive months folowing orthodontic treatment, and then, autologous iliac graft was performed folowed by another 3 consecutive months of wearing orthodontic retainer. RESULTS AND CONCLUSION:There were significant differences between groups A and C in terms of SNA, SNB, ANB, U1-NA and L1-NB (P < 0.01). Group B was significantly higher than the group A in SNB and L1/NB (P < 0.05). Compared with the group B, the SNB and U1/NA were reduced, while the SNA and L1/NB were increased significantly in the group C (P < 0.05). These findings indicate that for complete unilateral cleft lip and palate patients, the orthodontic treatment before and after bone grafting is better than simple pre- or post-grafting orthodontic treatment, which is conductive to the stability of corrected maxila.