DOI: 10.25881/20728255_2021_16_4_88

Authors

Fedotov R.N.1, Topol’nickij O.Z.1, Shuba M.I.1, Yakovlev S.V.1, Zangieva O.T.2, Epifanov S.A.2

1 Moscow State University of Medicine and Dentistry named after A.I. Evdokimova, Moscow

2 Pirogov National Medical and Surgical Center, Moscow

Abstract

Bilateral cleft lip and palate is one of the most severe pathologies of the maxillofacial areas in terms of anatomical and functional disorders. The percentage of occurrence of bilateral cleft lip and palate is 15–25% of the total pathology of the maxillofacial areas, of which about 50-80% are forms that lead to the development of the most severe forms of jaw deformities, such as mesial occlusion. The choice of tactics for the treatment of dental anomalies in this group of patients is a complex clinical task that requires a team approach of specialists of various profiles and the choice of optimal tactics of surgical treatment for each individual patient.

Aim: to increase the effectiveness of treatment of patients with bilateral cleft lip and palate with gnatic mesial occlusion by performing classical osteotomy or using the method of distraction osteogenesis.

Materials and methods: in the period from 2017 to 2021, 35 patients with bilateral cleft lip and palate were treated. Distraction osteogenesis was performed in 20 patients, and simultaneous movement of the jaws was performed in 15 patients by the method of classical osteotomy Le Fort-1.

Keywords: bilateral cleft lip and palate, orthognathic surgery, distraction osteogenesis, digital planning.

References

1. Chujkin SV, Persin LS, Davletshin NA. Vrozhdennaya rasshchelina verhnej guby i nyoba. M.: MIA, 2008. 363 р. (In Russ).

2. Fedotov RN. Planirovanie i taktika ortognaticheskogo hirurgicheskogo lecheniya pacientov posle hejlo- i uranoplastiki. [dissertation]. M., 2010. (In Russ).

3. Davletshin NA. Reabilitaciya detej s vrozhdyonnoj rasshchelinoj verhnej guby i nyoba v respublike Bashkortostan. [dissertation]. M. 2009. (In Russ).

4. Davydov BN. Deformacii licevogo skeleta u bol’nyh s rasshchelinoj verhnej guby i neba. Tver’: RIO TGMA, 1999. 104 р. (In Russ).

5. Cheung LK, Chua HD, Haag MB. Cleft maxillary distraction versus ortognatic surgery: clinical morbidities and surgical relapse. J. Plastic and Reconstr. Surg. 2005; 18(4): 996-1008.

6. Nivaldo A, Cassio E. Cleft lip and palate treatment: a comprehensive guide. Germany, 2018. p.396.

7. Adi RaRachmiel Management of Maxillary Cleft Deficiency — distraction osteogenesis vs cjnventional ortognathic surgery, Japan CLEFT. 2019. Р.121.

8. Kim, Jeenam, Uhm, Ki-il, Shin, Donghyeok, Lee, Jina, Choi, Hyungon. Maxillary Distraction Osteogenesis Using a Rigid External Distractor. Which Clinical Factors Are Related With Relapse? Journal of Craniofacial Surgery. 2015; 26(4): 1178-1181.

9. Heibuchel K., Kuijpers-Jagtman A. Maxillary and mandibulary dental-arch dimensions and occlusion in bilateral cleft lip and palate patients from 3 to 17 years of age. Cleft palate. Craniofacial J. 1997; 34(1): 21-26.

For citation

Fedotov R.N., Topol’nickij O.Z., Shuba M.I., Yakovlev S.V., Zangieva O.T., Epifanov S.A. Orthognathic surgery, distraction osteogenesis and digital planning in patients with bilateral cleft lip and palate. Bulletin of Pirogov National Medical & Surgical Center. 2021;4(16):88-92. (In Russ.) https://doi.org/10.25881/20728255_2021_16_4_88