What is the relapse after Le Fort I maxillary advancement in cleft lip and palate patients? A systematic review
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REVIEW ARTICLE
What is the relapse after Le Fort I maxillary advancement in cleft lip and palate patients? A systematic review Bibiana Dalsasso Velasques 1 Cristina Braga Xavier 5
&
Lucas Borin Moura 2 & João Roig Martins 3 & Melissa Feres Damian 4 &
Received: 17 May 2020 / Accepted: 9 September 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Le Fort I osteotomy is the most common procedure for maxillary advancement in cleft patients, and a significant relapse is expected in the postoperative period. This study purpose is to evaluate the maxillary relapse and associated factors in cleft lip and palate (CLP) patients submitted to standard Le Fort I advancement. This systematic review sought studies in PubMed, SCOPUS, and Cochrane and included papers that evaluated the maxillary relapse with at least 1-year postoperative period. The quality assessment was adapted following PRISMA statement. The initial electronic search found 345 papers, and the final selection included 10 studies. In total, 275 CLP patients were evaluated 198 had unilateral CLP and 41 had bilateral CLP. Isolated maxillary advancement was performed in 166 patients, while 109 had bimaxillary surgery. The mean relapse in horizontal and vertical plane was 1.2 mm (19.7%) and 1.0 mm (29.4%), respectively. In conclusion, a relapse after maxillary advancement in patients with CLP is expected, being higher in vertical plane. Patients with UCLP and those who underwent bimaxillary surgery had a higher relapse rate. Due to the miscellaneous data and methodologies, future prospective clinical trials should apply rigorous selection of CLP patients sample and methods for variable analysis to obtain more accurate results. Keywords Cleft . Relapse . Stability . Maxillary osteotomy
Introduction The cleft lip and palate (CLP) are facial and oral deformities that affect around 1 in 700 live births and are one of the most common congenital abnormalities [1]. The cause is multifactorial and includes genetic factors, chemical and/or radiation exposure, maternal health, and malnutrition status [2].
Usually, males are more likely to be affected by CLP. The unilateral cleft lip and palate (UCLP) is three times more frequent than bilateral cleft lip and palate (BCLP) [3], and the left side is most affected when the cleft is unilateral [4]. CLP are frequently associated with maxillary hypoplasia. The degree of hypoplasia is varied and becomes progressively perceptible with the development of the patient, since the
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10006-020-00906-y) contains supplementary material, which is available to authorized users. * Bibiana Dalsasso Velasques [email protected]
1
Oral and Maxillofacial Surgery Department, Pontifical Catholic University of Rio Grande do Sul, Ipiranga Avenue, 6681 Partenon, Porto Alegre, RS 90619-900, Brazil
Lucas Borin Moura [email protected]
2
Catholic University of Pelotas, Pelotas, RS, Brazil
João Roig Martins [email protected]
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