Longitudinal evaluation of bone-anchored maxillary protraction in patients with complete cleft lip and palate

• Autor(a) principal: Rosar, Júlia Petruccelli
• Data de Publicação: 2024
• Tipo de documento: Dissertação
• Idioma: eng
• Título da fonte: Biblioteca Digital de Teses e Dissertações da USP
• Texto Completo: https://www.teses.usp.br/teses/disponiveis/61/61132/tde-26042024-140422/
• topic: Angle class III; Cleft lip; Cleft palate; Fenda labial; Fissura palatina; Má oclusão de Angle Classe III; Malocclusion; Orthodontic anchorage procedures; Procedimentos de ancoragem ortodôntica

Introduction: Bone-anchored maxillary protraction (BAMP) using intermaxillary elastics has shown positive outcomes in patients with complete cleft lip and palate. There is a need to follow these patients to assess the stability of these results at the end of growth. Objective: To assess a longitudinal evaluation of bone-anchored maxillary protraction in patients with complete cleft lip and palate. Methods: The sample consisted of 30 patients with complete unilateral cleft lip and palate, with an average age of 11.8 years at the beginning of BAMP therapy. Cone-beam computed tomography scans (CBCT) were obtained at the beginning of BAMP therapy (T1) and at the end of 18 months of treatment (T2). Individuals who achieved a positive overjet at the end of BAMP therapy received compensatory orthodontic treatment (nonsurgical group), while those who did not achieve a positive overjet underwent ortho-surgical treatment during the second phase (surgical group). After an average of 6.77 years post-BAMP, radiographic follow-up (T3) was performed. Cephalometric analyses were performed on T1, T2, and T3 images with 11 variables. Comparisons between phases in the nonsurgical group were conducted using ANOVA, Friedman, and Tukey tests, and linear regression analysis was performed to assess changes between T2 and T1. The significance level was set at 5%. Results: 53.8% of patients were submitted to ortho-surgical treatment. The outcomes of BAMP therapy remained stable between T3 and T2 in the nonsurgical group. Conclusions: The variables SNA, SNB, Wits, FMA and overjet at T1 were responsible for 20% of the surgical and nonsurgical outcomes. Differences between T2 and T1 were responsible for 27.1% of outcomes. Hyperdivergent patients had a greater need for orthognathic surgery for anteroposterior correction. More significant overjet results during BAMP therapy were associated with nonsurgical outcome at the end of growth.