Need for orthognathic surgery in cleft patients from Northern Finland

Authors

  • Mateusz Podleśny Research Unit of Population Health, Faculty of Medicine, University of Oulu, Finland; Oral and Maxillofacial Surgeon, Oulu University Hospital, Finland. Medical Research Center Oulu, Oulu, Finland https://orcid.org/0009-0006-0815-9798
  • Leena Ylikontiola Research Unit of Population Health, Faculty of Medicine, University of Oulu, Finland; Oral and Maxillofacial Surgeon, Oulu University Hospital, Finland. Medical Research Center Oulu, Oulu, Finland https://orcid.org/0000-0001-7874-274X
  • George K. Sándor Oral and Maxillofacial Surgeon, Plastic Surgeon, Oulu University Hospital, Finland; Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland https://orcid.org/0000-0003-3125-5172
  • Ville Vuollo Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland https://orcid.org/0000-0001-6604-8806
  • Virpi Harila Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland; Orthodontist, Oulu University Hospital, Oulu, Finland https://orcid.org/0000-0002-5272-6300

DOI:

https://doi.org/10.2340/aos.v83.40338

Keywords:

Cleft lip, cleft palate, cleft lip and palate, orthognathic surgery, Le Fort, adolescent orthodontics

Abstract

Objective: Northern Finland has a unique distribution of clefts compared to the rest of Europe and Finland. This may reflect the need for orthognathic surgery among Northern Finland’s patient pool. The aim of this study was to compare previously operated patients aged 18 years or older with cleft lip, cleft lip and alveolus, cleft lip and palate, cleft palate and to evaluate the need for orthognathic surgery in order to achieve a stable and functional occlusion. 

Materials and methods: The study group consisted of all 18-years-old cleft patients treated in the Oulu Cleft Center. The total amount of patients was 110. The patients were compared retrospectively using patients’ hospital records. The majority of patients did not have any cleft-associated syndrome. The need for maxillary or bimaxillary orthognathic or corrective-jaw surgery was evaluated by the Oulu Cleft Team. A descriptive and statistical analysis was used to determine the need for orthognathic surgery according to sex and cleft type.

Results: There were nineteen patients of the total of 110 patients who met the criteria requiring corrective-jaw surgery (17,3%). In total 12 males (25,0%) and 7 females (11,3%) were evaluated for the need of orthognathic surgery. Sixteen of the 19 patients had palatal involvement of the cleft.

Conclusions: The need for orthognathic surgery was greater in the cleft lip palate and cleft palate patient groups compared to cleft lip alveolus or cleft lip groups. This study also found that males from Northern Finland need surgery more often than females.

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References

Lithovius RH, Ylikontiola LP, Harila V, et al. A descriptive epidemiology study of cleft lip and palate in Northern Finland. Acta Odontol Scand. 2014;72(5):372–75. https://doi.org/10.3109/00016357.2013.840737 DOI: https://doi.org/10.3109/00016357.2013.840737

Harila V, Ylikontiola LP, Palola R, et al. Maxillary arch dimensions in cleft infants in Northern Finland. Acta Odontol Scand. 2013; 71 (3–4):930–6. https://doi.org/10.3109/00016357.2012.734420 DOI: https://doi.org/10.3109/00016357.2012.734420

Schutte BC, Murray, JC. The many faces and factors of orofacial clefts. Hum Mol Genet. 1999;8(10):1853–9. https://doi.org/10.1093/hmg/8.10.1853 DOI: https://doi.org/10.1093/hmg/8.10.1853

Sivertsen Å, Wilcox AJ, Skjaerven R, et al. Familial risk of oral clefts by morphological type and severity: population based cohort study of first degree relatives. BMJ. 2008;336(7641):432–4. https://doi.org/10.1136/bmj.39458.563611.AE DOI: https://doi.org/10.1136/bmj.39458.563611.AE

Więckowska B, Materna-Kiryluk A, Wiśniewska K, et al. The detection of areas in Poland with an increased prevalence of isolated cleft lip with or without cleft palate. Ann Agric Environ Med. 2015;22(1):110–17. https://doi.org/10.5604/12321966.1141379 DOI: https://doi.org/10.5604/12321966.1141379

Brito LA, Meira JGC, Kobayashi GS, et al. Genetics and management of the patient with orofacial cleft. Plast Surg Int. 2012;2012:1–11. https://doi.org/10.1155/2012/782821 DOI: https://doi.org/10.1155/2012/782821

McDonnell R, Owens M, Delany C, et al. Epidemiology of orofacial clefts in the east of Ireland in the 25-year period 1984–2008. Cleft Pal-ate-Craniofac J. 2014; 51(4):e63–9. https://doi.org/10.1597/11-299 DOI: https://doi.org/10.1597/11-299

Rautio J, Somer M, Pettay M, et al. Treatment of cleft lip and palate in Finland. Duodecim [Internet]. 2010 [cited 04-03-2021];126(11):1286–94. Available from: https://pubmed.ncbi.nlm.nih.gov/20681351/

Koillinen H, Wong F, Rautio J, et al. Mapping of the second locus for the Van der Woude syndrome to chromosome 1p34. Eur J Hum Genet. 2001;9(10):747–52. https://doi.org/10.1038/sj.ejhg.5200713 DOI: https://doi.org/10.1038/sj.ejhg.5200713

Heliövaara A, Rautio J. A comparison of craniofacial cephalometric morphology and the later need for orthognathic surgery in 6-year-old cleft children. J Cranio-Maxillofacial Surg. 2011; 39(3):173–6. https://doi.org/10.1016/j.jcms.2010.03.020 DOI: https://doi.org/10.1016/j.jcms.2010.03.020

Gustafsson C, Heliövaara A, Rautio J, et al. Long-term follow-up of bilateral cleft lip and palate: incidence of speech-correcting surgeries and Fistula formation. Cleft Palate Craniofacial J. 2023;60(10):1241–9. https://doi.org/10.1177/10556656221102816 DOI: https://doi.org/10.1177/10556656221102816

Ore CD, Schoenbrunner A, Brandel M, et al. Incidence of le fort surgery in a mature cohort of patients with cleft lip and palate. Ann Plastic Surg. 2017;78(5):S199–203. https://doi.org/10.1097/SAP.0000000000001049 DOI: https://doi.org/10.1097/SAP.0000000000001049

Meazzini MC, Capello AV, Ventrini F, et al. Long-term follow-up of UCLP patients: surgical and orthodontic burden of care during growth and final orthognathic surgery need. Cleft Palate-Craniofacial J. 2015;52(6):688–97. https://doi.org/10.1597/12-211 DOI: https://doi.org/10.1597/12-211

Broome M, Herzog G, Hohlfeld J, et al. Influence of the primary cleft palate closure on the future need for orthognathic surgery in unilat-eral cleft lip and palate patients. J Craniofac Surg. 2010;21(5):1615–8. https://doi.org/10.1097/scs.0b013e3181ef2eed DOI: https://doi.org/10.1097/SCS.0b013e3181ef2eed

Park HM, Kim PJ, Kim HG, et al. Prediction of the need for orthognathic surgery in patients with cleft Lip and/or palate. J Craniofacial Surg. 2015;26(4):1159–62. https://doi.org/10.1097/SCS.0000000000001605 DOI: https://doi.org/10.1097/SCS.0000000000001605

Eslami S, Faber J, Fateh A, et al. Treatment decision in adult patients with class III malocclusion: surgery versus orthodontics. Prog Orthod. 2018;19(1):28. https://doi.org/10.1186/s40510-018-0218-0 DOI: https://doi.org/10.1186/s40510-018-0218-0

James JN, Costello BJ, Ruiz RL. Management of cleft lip and palate and cleft orthognathic considerations. Oral Maxillofacial Surg Clin N Am. 2014;26(4):565–72. https://doi.org/10.1016/j.coms.2014.08.007 DOI: https://doi.org/10.1016/j.coms.2014.08.007

Chua HDP, Hgg MB, Cheung LK. Cleft maxillary distraction versus orthognathic surgery-which one is more stable in 5 years? Oral Surg Oral Med Oral Pathol Oral Radiol Endodontol. 2010;109(6):803–14. https://doi.org/10.1016/j.tripleo.2009.10.056 DOI: https://doi.org/10.1016/j.tripleo.2009.10.056

Rafal N. Historical outline of orthognatic surgery. Dent Med Prob [Internet]. 2021 [cited 05-13-2021];51(1). Available from: https://www.researchgate.net/publication/285596552_Historical_Outline_of_Orthognatic_Surgery

Bhatia S, Bocca A, Jones J, et al. Le Fort i advancement osteotomies of 1 cm or more. How safe or stable? Br J Oral Maxillofacial Surg. 2016;54(3):346–50. https://doi.org/10.1016/j.bjoms.2015.09.025 DOI: https://doi.org/10.1016/j.bjoms.2015.09.025

Sándor GK, Leeper HA, Carmichael RP. Risks and benefits of orthognathic surgery – speech and velopharyngeal function. Oral Maxillofacial Surg Clin N Am. 1997;9(2):147–65. https://doi.org/10.1016/S1042-3699(20)30988-2 DOI: https://doi.org/10.1016/S1042-3699(20)30988-2

Schwarz C, Gruner E. Logopaedic findings following advancement of the Maxilla. J Maxillofac Surg. 1976;4(C):40–55. https://doi.org/10.1016/S0301-0503(76)80007-0 DOI: https://doi.org/10.1016/S0301-0503(76)80007-0

Watts GD, Antonarakis GS, Forrest CR, et al. Single versus segmental maxillary osteotomies and long-term stability in unilateral cleft lip and palate related malocclusion. J Oral Maxillofacial Surg. 2014;72(12):2514–21. https://doi.org/10.1016/j.joms.2014.07.005 DOI: https://doi.org/10.1016/j.joms.2014.07.005

Politis C. Life-threatening haemorrhage after 750 le Fort i osteotomies and 376 SARPE procedures. Int J Oral Maxillofac Surg. 2015;41(6):702–8. https://doi.org/10.1016/j.ijom.2012.02.015 DOI: https://doi.org/10.1016/j.ijom.2012.02.015

De Gijt JP, Gül A, Tjoa STH, et al. Follow up of surgically-assisted rapid maxillary expansion after 6.5 years: skeletal and dental effects. Br J Oral Maxillofacial Surg. 2017;55(1):56–60. https://doi.org/10.1016/j.bjoms.2016.09.002 DOI: https://doi.org/10.1016/j.bjoms.2016.09.002

Bortolotti F, Solidoro L, Bartolucci ML, et al. Skeletal and dental effects of surgically assisted rapid palatal expansion: a systematic review of randomized controlled trials. Eur J Orthod. 2020;42(4): 434–40. https://doi.org/10.1093/ejo/cjz057 DOI: https://doi.org/10.1093/ejo/cjz057

Gurler G, Kaptan Akar N, Delilbasi C, et al. Skeletal changes following surgically assisted rapid maxillary expansion (SARME). Eur Oral Res. 2019;94–8. https://doi.org/10.26650/eor.2018.465 DOI: https://doi.org/10.26650/eor.2018.465

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Published

2024-04-11