Abstract
The results of surgical orthodontict reatment for cleft lip and palate pati entsw ere evaluated retrospectively. Fifteen adult unilateral cleft lip and palate patients who received surgical orthodontic treatment and obtainedg ood occlusionw ere divided into two g roups: 1) 7 patientsw ho received m an. dibular sagittal splitting osteotomy only (mandibular group) and 2) 8 patients who received maxillary Le Fort I ostetomy and mandibular sagittal splitting osteotomy simultaneously (two -jaw group).
Morphological comparisons between these two groups were made by using lateral cephalogram s taken at the following four stages: at the beginning of orthodontic treatment, just before surgery, just after surgery, and at more than 8 months after surgery.
The results were as follows:
1) Skeletal maxillo-mandibula r disharmony was caused by the rertoposition of the ma xilla in the majority of the cases. This disharmony was greater in the two -jaw group than that in the mandibu lar group.
2) The amount of surgical repositioning and subsequent skeletal changes were also greater in the two-jaw group. The increased nasolabial angle were found in the two -jaw group during surgery.
3) Tendency of the maxillary postero-superior displacement coupled with mandibular antero -sup e rior displacement during postsurgical orthodontic treatment was markedly found in the two -jaw group. On the contrary, a specific displacement tendency was found in the mandibular group. The changes of over jet and over bite in this period were greater in the mandibular group than that in the two -jaw group.
4) Two-jaw surgery was chosen for cases needing much surgical repositioning, while mandibular sagittal splitting osteotomy only was selected for those needing slight surgical repositioning. For the case needing moderate repositioning, two-jaw surgery was selected in case of severe maxillary retrusion or remarkable skeletal maxillo-mandibular disharmony.
