Evaluation of a New Protocol for the Correction of Midface Deficiency in Growing Patients with Cleft Lip and Palate Using Modified Surgical Miniplates

Abstract

This study was carried to evaluate the efficiency of a new protocol for the correction of midface deficiency in growing patients with surgically repaired complete UCLP using modified surgical miniplates. Fourteen patients with age ranging from nine to 13 years were selected from the outpatient clinic of Orthodontic Department and Cleft-Care-Center affiliated to the Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Ain Shams University. All subjects were in pre-pubertal stage of skeletal maturity, with skeletal Class III malocclusion primarily due to maxillary deficiency, in the mixed dentition with erupted lower permanent lateral incisors or full permanent dentition stages, with anterior crossbite or edge-to-edge incisor relationship and unilateral or bilateral posterior cross-bite. They were all medically free and none of them had previous orthopedic or orthodontic treatment. Patients were randomly allocated to one of the two treatment groups; Group I: BAMP not preceded by maxillary expansion and Group II: BAMP preceded by maxillary expansion using fan-shaped expander. The custom-made modified surgical titanium miniplates designed for the study were inserted in all the patients under general anesthesia and loaded with Class III intermaxillary elastics after three weeks healing period to start the maxillary protraction protocol.