Maxillary Shape After Cleft Surgery: Comparing Two Protocols
F. Girinon · S. Ketoff · Q. Hennocq · … · A. Picard · R.H. Khonsari
J Stomatol Oral Maxillofac Surg · 2019 · 120(5):406-409
Does the timing of surgery influence maxillary growth in children operated on for a cleft? Dr Serge Ketoff took part in this morphometric study comparing two management protocols.
In brief
- Assessing outcomes in cleft surgery is a technical challenge.
- Two surgical protocols are compared at the same age (5 years) using 3D morphometrics.
- The functional approach yields better maxillary dimensions.
Objective
Outcome assessment in cleft surgery requires dedicated morphometric tools. Two cohorts of children managed under different protocols were compared at a similar age, analysing palatal shape with geometric morphometrics.
Method
Protocol 1: early lip closure (1-3 months) then combined soft and hard palate closure (6-9 months). Protocol 2: later combined lip and soft palate closure (6 months) followed by hard palate closure (18 months). CBCT images at 5 years allowed comparison of palatal shape.
Results
The inter-canine distance was significantly narrower in protocol 1. The functional approach (protocol 2) achieves larger inter-canine distances and more anatomical premaxillary positions at 5 years. This is the first study comparing these protocols using 3D CBCT data and geometric morphometrics.
Key points
- 3D morphometrics applied to cleft surgery.
- Functional approach = better-developed maxilla at 5 years.
- Novel CBCT-based comparison.
- Follow-up to puberty needed for long-term conclusions.
Reference : Girinon F, Ketoff S, Hennocq Q, et al. Maxillary shape after primary cleft closure and before alveolar bone graft in two different management protocols: a comparative morphometric study. J Stomatol Oral Maxillofac Surg. 2019;120(5):406-409.
PubMed · DOI · Google Scholar · ORCID