A Three Dimensional Assessment of Maxillary Advancement using Tandem appliance vs Face Mask in Individuals with Complete Cleft Lip and Palate; a Randomized Control Trial

Abstract

This study was carried to evaluate the efficiency of a new protocol for correction of mid face deficiency in growing patients with surgically repaired complete unilateral cleft lip and palate (UCLP) using Tandem traction bow appliance and compare the result with the Face Mask appliance. Twenty patients with age range from nine to thirteen years were selected from the outpatient clinic of orthodontic department, Faculty of Dentistry, Ain Shams University. All the subjects were in the prepubertal stage of skeletal maturity with surgically repaired unilateral complete cleft lip, alveolar process and secondary palate, skeletal class III malocclusion primarily due to maxillary retrusion, or a combination of maxillary retrusion and mandibular protrusion, with anterior cross bite or edge to edge incisor relationship and posterior cross bite and fully erupted first molars. They were all medically free, none of them had previous orthodontic or orthopedic treatment and none of them have any craniofacial syndrome other than cleft lip and palate. Patients were randomly allocated to one of the two treatment groups. Group I (Face Mask group) and group II (Tandem group). Cone beam computed tomography was taken before treatment and after treatment. A customized 3D cephalometric analysis relying on stable cranial structures was carried using in vivo 5 version 5.3.1 software to analyze treatment changes in the two treatment groups.