Cephalometric Predictors of Future need for Orthognathic Surgery in Korean Patients with Unilateral Cleft Lip and Palate Despite Long-term Use of Facemask with Miniplate
유상훈, 백승학, 최진영, 이종호, 김석화, 온성운,
소속 상세정보
유상훈 ( Yu Sang-Hun ) - Seoul National University School of Dentistry Department of Orthodontics
백승학 ( Baek Seung-Hak ) - Seoul National University School of Dentistry Department of Orthodontics
최진영 ( Choi Jin-Young ) - Seoul National University School of Dentistry Department of Oral and Maxillofacial Surgery
이종호 ( Lee Jong-Ho ) - Seoul National University School of Dentistry Department of Oral and Maxillofacial Surgery
김석화 ( Kim Suk-Wha ) - Seoul National University College of Medicine Department of Plastic and Reconstructive Surgery
온성운 ( On Sung-Woon ) - Seoul National University School of Dentistry Department of Oral and Maxillofacial Surgery
Abstract
Objective: To investigate the cephalometric predictors of the future need for orthognathic surgery in Korean patients with unilateral cleft lip and palate (UCLP) despite long-term use of facemask with miniplate (FMMP).
Methods: The sample consisted of 53 UCLP patients treated by a single orthodontist using an identical protocol. Lateral cephalograms were taken before commencement of FMMP therapy (T0; mean age, 10.45 years), after FMMP therapy (T1; mean age, 14.72 years), and at follow-up (T2; mean age, 18.68 years). Twenty-eight cephalometric variables were measured. At T2 stage, the subjects were divided into FMMP-Nonsurgery (n = 33, 62.3%) and FMMP-Surgery (n = 20, 37.7%) groups according to cephalometric criteria (point A-nasion-point B [ANB] < ?3°; Wits-appraisal < ?5 mm; and Harvold unit difference [HUD] > 34 mm for FMMP-Surgery group). Statistical analyses including discrimination analysis were performed.
Results: In FMMP-Surgery group, the forward position of the mandible at T0 stage was maintained throughout the whole stages and Class III relationship worsened with significant growth of the mandibular body and ramus and counterclockwise rotation of the maxilla and mandible at the T1 and T2 stages. Six cephalometric variables at T0 stage including ANB, anteroposterior dysplasia indicator, Wits-appraisal, mandibular body length, HUD, and overjet were selected as effective predictors of the future need for surgical intervention to correct sagittal skeletal discrepancies.
Conclusions: Despite long-term use of FMMP therapy, 37.7% of UCLP patients became candidates for orthognathic surgery. Therefore, differential diagnosis is necessary to predict the future need for orthognathic surgery at early age.
키워드
Unilateral cleft lip and palate; Cephalometric predictors; Orthognathic surgery; Facemask with miniplate
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