[Three-dimensional evaluation of stability of maxillary displacement after surgically assisted maxillary expansion in adult patients with cleft lip and palate].

Abstract

The aim of the study: Was to investigate the dynamics of maxillary movement after surgically assisted maxillary expansion in adult patients with cleft lip and palate.

Material and methods: The study involved 15 adult patients aged 18-47 divided into three groups based on upper jaw pathology. Group 1 consisted of 5 patients with the diagnosis of «Upper micrognathia», group 2 included 5 patients with «Upper micrognathia after a series of surgeries for unilateral cleft lip and palate» and group 3 comprised 5 patients with diagnosis of «Upper micrognathia after a series of surgeries for bilateral cleft lip and palate». Movement of the maxillary fragments was measured 3 and 6 months after activation using cone beam computed tomography and intraoral scanner data. The data was analyzed using specialized software Amira 5.4.5 to create a 3D-model of the upper jaw. This allowed for precise measurement and analysis of the movement of the maxilla over time.

Results: Despite the initial goal of surgically assisted maxillary expansion being to correct transverse deficits it has been found that spatial changes occur in all planes and axes. Patients with upper micrognathia resulting from bilateral cleft lip and palate are more likely to experience recurrence of displacement of the fragments of the upper jaw following expansion, compared to patients with a unilateral cleft during the postoperative period. The most favorable stability indicators were noted among patients without clefts.

Conclusion: Comparison of three-dimensional jaw models obtained from CT and intraoral scanning data allows for accurate visualization and calculation of changes occurring in the postoperative period and can be the method of choice in dynamic monitoring of patients.