Bone-anchored maxillary protraction in a patient with complete cleft lip and palate: A case report
Sagittal maxillary deficiency is frequently observed in patients with operated unilateral complete cleft of the lip and palate. Treatment for moderate to severe Class III malocclusion usually relies on LeFort I surgery for maxillary advancement after the end of growth. This case report describes bon...
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| Published in | American journal of orthodontics and dentofacial orthopedics Vol. 153; no. 2; pp. 290 - 297 |
|---|---|
| Main Authors | , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
Elsevier Inc
01.02.2018
|
| Online Access | Get full text |
| ISSN | 0889-5406 1097-6752 1097-6752 |
| DOI | 10.1016/j.ajodo.2016.10.044 |
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| Abstract | Sagittal maxillary deficiency is frequently observed in patients with operated unilateral complete cleft of the lip and palate. Treatment for moderate to severe Class III malocclusion usually relies on LeFort I surgery for maxillary advancement after the end of growth. This case report describes bone-anchored maxillary protraction in a 10-year-old white boy with unilateral complete cleft of the lip and palate. His interarch relationship was diagnosed as GOSLON index 5 before treatment with a negative overjet of 3.2 mm. The orthopedic traction was started 4 months after secondary alveolar bone graft surgery and before comprehensive orthodontic treatment. Class III elastics were used full time for 18 months. After treatment, the interarch relationship was GOSLON index 1 with a positive overjet. The SNA angle increased by 6.50° and A-Na Perp increased by 3.8 mm, leading to marked improvement in facial convexity (+14.6°). No posterior rotation of the mandible occurred with a slight closure of the gonial angle. Visualization of 3-dimensional color-coded maps showed an overall forward maxillary displacement. The bone-anchored maxillary protraction results for this patient are a promising orthopedic therapy for patients with unilateral complete cleft of the lip and palate, with the advantage of achieving much earlier improvement of facial esthetics and functional occlusion, compared with LeFort I surgery at skeletal maturity.
•Bone-anchored maxillary protraction (BAMP) was used in a patient with CLP.•The protocol for BAMP therapy in patients with CLP is provided.•BAMP therapy produced important maxillary protraction in the patient.•BAMP could reduce the need for orthognathic surgery in CLP patients. |
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| AbstractList | Sagittal maxillary deficiency is frequently observed in patients with operated unilateral complete cleft of the lip and palate. Treatment for moderate to severe Class III malocclusion usually relies on LeFort I surgery for maxillary advancement after the end of growth. This case report describes bone-anchored maxillary protraction in a 10-year-old white boy with unilateral complete cleft of the lip and palate. His interarch relationship was diagnosed as GOSLON index 5 before treatment with a negative overjet of 3.2 mm. The orthopedic traction was started 4 months after secondary alveolar bone graft surgery and before comprehensive orthodontic treatment. Class III elastics were used full time for 18 months. After treatment, the interarch relationship was GOSLON index 1 with a positive overjet. The SNA angle increased by 6.50° and A-Na Perp increased by 3.8 mm, leading to marked improvement in facial convexity (+14.6°). No posterior rotation of the mandible occurred with a slight closure of the gonial angle. Visualization of 3-dimensional color-coded maps showed an overall forward maxillary displacement. The bone-anchored maxillary protraction results for this patient are a promising orthopedic therapy for patients with unilateral complete cleft of the lip and palate, with the advantage of achieving much earlier improvement of facial esthetics and functional occlusion, compared with LeFort I surgery at skeletal maturity.Sagittal maxillary deficiency is frequently observed in patients with operated unilateral complete cleft of the lip and palate. Treatment for moderate to severe Class III malocclusion usually relies on LeFort I surgery for maxillary advancement after the end of growth. This case report describes bone-anchored maxillary protraction in a 10-year-old white boy with unilateral complete cleft of the lip and palate. His interarch relationship was diagnosed as GOSLON index 5 before treatment with a negative overjet of 3.2 mm. The orthopedic traction was started 4 months after secondary alveolar bone graft surgery and before comprehensive orthodontic treatment. Class III elastics were used full time for 18 months. After treatment, the interarch relationship was GOSLON index 1 with a positive overjet. The SNA angle increased by 6.50° and A-Na Perp increased by 3.8 mm, leading to marked improvement in facial convexity (+14.6°). No posterior rotation of the mandible occurred with a slight closure of the gonial angle. Visualization of 3-dimensional color-coded maps showed an overall forward maxillary displacement. The bone-anchored maxillary protraction results for this patient are a promising orthopedic therapy for patients with unilateral complete cleft of the lip and palate, with the advantage of achieving much earlier improvement of facial esthetics and functional occlusion, compared with LeFort I surgery at skeletal maturity. Sagittal maxillary deficiency is frequently observed in patients with operated unilateral complete cleft of the lip and palate. Treatment for moderate to severe Class III malocclusion usually relies on LeFort I surgery for maxillary advancement after the end of growth. This case report describes bone-anchored maxillary protraction in a 10-year-old white boy with unilateral complete cleft of the lip and palate. His interarch relationship was diagnosed as GOSLON index 5 before treatment with a negative overjet of 3.2 mm. The orthopedic traction was started 4 months after secondary alveolar bone graft surgery and before comprehensive orthodontic treatment. Class III elastics were used full time for 18 months. After treatment, the interarch relationship was GOSLON index 1 with a positive overjet. The SNA angle increased by 6.50° and A-Na Perp increased by 3.8 mm, leading to marked improvement in facial convexity (+14.6°). No posterior rotation of the mandible occurred with a slight closure of the gonial angle. Visualization of 3-dimensional color-coded maps showed an overall forward maxillary displacement. The bone-anchored maxillary protraction results for this patient are a promising orthopedic therapy for patients with unilateral complete cleft of the lip and palate, with the advantage of achieving much earlier improvement of facial esthetics and functional occlusion, compared with LeFort I surgery at skeletal maturity. •Bone-anchored maxillary protraction (BAMP) was used in a patient with CLP.•The protocol for BAMP therapy in patients with CLP is provided.•BAMP therapy produced important maxillary protraction in the patient.•BAMP could reduce the need for orthognathic surgery in CLP patients. Sagittal maxillary deficiency is frequently observed in patients with operated unilateral complete cleft of the lip and palate. Treatment for moderate to severe Class III malocclusion usually relies on LeFort I surgery for maxillary advancement after the end of growth. This case report describes bone-anchored maxillary protraction in a 10-year-old white boy with unilateral complete cleft of the lip and palate. His interarch relationship was diagnosed as GOSLON index 5 before treatment with a negative overjet of 3.2 mm. The orthopedic traction was started 4 months after secondary alveolar bone graft surgery and before comprehensive orthodontic treatment. Class III elastics were used full time for 18 months. After treatment, the interarch relationship was GOSLON index 1 with a positive overjet. The SNA angle increased by 6.50° and A-Na Perp increased by 3.8 mm, leading to marked improvement in facial convexity (+14.6°). No posterior rotation of the mandible occurred with a slight closure of the gonial angle. Visualization of 3-dimensional color-coded maps showed an overall forward maxillary displacement. The bone-anchored maxillary protraction results for this patient are a promising orthopedic therapy for patients with unilateral complete cleft of the lip and palate, with the advantage of achieving much earlier improvement of facial esthetics and functional occlusion, compared with LeFort I surgery at skeletal maturity. |
| Author | Yatabe, Marília Garib, Daniela de Clerck, Hugo Gregório, Leonardo de Souza Faco, Renato André Cevidanes, Lucia |
| Author_xml | – sequence: 1 givenname: Daniela surname: Garib fullname: Garib, Daniela email: dgarib@usp.br organization: Department of Orthodontics, Bauru Dental School, Hospital of Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, São Paulo, Brazil – sequence: 2 givenname: Marília surname: Yatabe fullname: Yatabe, Marília organization: Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, São Paulo, Brazil – sequence: 3 givenname: Renato André surname: de Souza Faco fullname: de Souza Faco, Renato André organization: Hospital of Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, São Paulo, Brazil – sequence: 4 givenname: Leonardo surname: Gregório fullname: Gregório, Leonardo organization: Hospital of Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, São Paulo, Brazil – sequence: 5 givenname: Lucia surname: Cevidanes fullname: Cevidanes, Lucia organization: Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Mich – sequence: 6 givenname: Hugo surname: de Clerck fullname: de Clerck, Hugo organization: Department of Orthodontics, School of Dentistry, University of North Carolina, Chapel Hill, NC |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/29407507$$D View this record in MEDLINE/PubMed |
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| Title | Bone-anchored maxillary protraction in a patient with complete cleft lip and palate: A case report |
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