Abstract
Background
Maxillary hypoplasia is a common sequela of cleft lip and palate (CLP), often requiring surgical correction through maxillary advancement osteotomy. However, the resulting aesthetic outcome can be unpredictable. Frequently, these cases involve maxillary lateral incisor agenesis, managed either by preserving the space for dental rehabilitation or through orthodontic space closure.
Purpose
To investigate the correlation between aesthetic and occlusal outcomes and the management of the missing maxillary lateral incisor space. Secondary objectives included assessing the relationship between aesthetic and occlusal scores and space management, nasolabial angle, the extent of maxillary advancement, and the maxillary incisor axis.
Study design
Retrospective cohort study.
Patients/participants
This retrospective study analyzed 47 patients with CLP sequelae who underwent maxillary advancement surgery between 2008 and 2022 at our center.
Intervention
Aesthetic evaluation and occlusal evaluation.
Main outcome variables
Aesthetic evaluation and occlusal evaluation were independently conducted by 5 examiners. Aesthetic and occlusal scores were deemed satisfactory if they exceeded ≥30 of 40 and 15 of 20, respectively. These outcomes were correlated with the preservation of the maxillary lateral incisor space, extent of maxillary advancement, nasolabial angle, and maxillary incisor axis.
Results
No significant improvement in aesthetic or occlusal outcomes was observed, regardless of whether the maxillary lateral incisor space was preserved. However, space closure was associated with greater maxillary advancement (P = .025).
Conclusions and relevance
Orthodontic space closure may lead to better outcomes. Further research involving larger sample sizes and consideration of additional factors is needed to determine the optimal approach for each patient.
Keywords
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