Prognosis Prediction of Facemask With Miniplate Therapy in Patients With Cleft Lip With/Without Palate.

Objective: To investigate the prognosis prediction of facemask with miniplate (FMMP) therapy in patients with cleft lip with/without palate (CL/P).

Materials and methods: The subjects were 103 CL/P patients treated with FMMP therapy. Twenty-five cephalometric variables were measured at preadolescence (T0) and young adulthood (T1). At T1, the subjects were allocated into the FMMP-surgery group (1) when three of the following conditions were met: ANB < -3°, Wits appraisal < -5 mm, APDI > 90° and AB-MP < 60° and (2) when patients were undergoing presurgical orthodontic treatment or had already undergone orthognathic surgery. The mean ages of T0 and T1 and the mean FMMP duration were 8.4, 19.5 and 5.2 years in the FMMP-surgery group (27.2%, n = 28) and 8.5, 18.1 and 4.1 years in the FMMP-nonsurgery group (72.8%, n = 75). Binary logistic regression analysis and receiver operating characteristics analysis were performed.

Results: Compared to the FMMP-nonsurgery group, the FMMP-surgery group exhibited a more forward mandibular position and a flatter maxillary occlusal plane at T0, a similar amount of change in the position of point-A, greater forward mandibular growth with larger counterclockwise rotation and an increase in posterior vertical dimension, leading to exacerbation of the skeletal Class III pattern during T1-T0. Four T0 cephalometric predictors (A to N-perpendicular, APDI, FMA and ODI) were identified with high prediction values of accuracy (85.4%) and sensitivity (prediction/actual FMMP-nonsurgery, 93.3%) and moderate value of specificity (prediction/actual FMMP-surgery, 64.3%).

Conclusion: These four T0 cephalometric variables were identified as predictors for determining the prognosis in FMMP treatment for patients with CL/P.