Le Fort I osteotomy and V-Y closing in patients with sequelae after labio-maxillo-palatal clefts

Abstract

Introduction: It is known that patients with cleft jaw have a hypoplasic jaw mainly due to surgery during the first years of life. The lowering and the advance of the jaw after Le Fort I osteotomy corrects the occlusal layer and vertical dimension of the face and also repositions soft parts, nose included. The lack of development of the upper lip, requires surgical procedures, V-Y Plasty is the recommended procedure. Purpose: Our goal was to evaluate the value of the lowering and the advance of jaw surgery, associated or not with surgery of the mandible, and stability in time of occlusion and the new facial harmony. Materials and methods: The study was conducted on a group of 9 patients, including 6 girls and 3 boys, who were hospitalized in the last 3 years in Iasi OMF (Oro-Maxillo-Facial) Surgery, sequelae after complete unilateral or bilateral clefts, with ages between 16 and 32. Of these only 2 patients received surgery for the Mandible. The remaining 7 underwent only Le Fort I osteotomy. 5 patients underwent V-Y plasty to lengthen the upper lip. Results: Measurements made on lateral cephalometric to asses the advance(average 7 mm) and lowering the jaw (average 6 mm). Height of the upper lip increased by 3 mm. Measurements were performed one week preop and one week postop. Measurements made one year postop showed in average a relapse of 3 mm for the advance and 2 mm in rising of the jaw. Results of facial harmony and soft tissue remained constant.