Skeletal stability of maxillary advancement with and without a mandibular reduction in the cleft lip and palate patient

The stability of surgical maxillary advancement in a consecutive series of patients with cleft lip and palate who underwent Le Fort I osteotomy with and without simultaneous mandibular setback surgery was evaluated. Preoperative, postoperative, and follow-up lateral cephalograms of 21 patients were assessed to compare differences in surgical movement and postoperative relapse between two groups: those who underwent maxillary surgery alone and those who underwent bimaxillary surgery. Differences in the number of patients who experienced relapse of <2 mm, 2-4 mm, and >4 mm between the groups were also compared. Mean advancement of the cleft maxilla was 5.5 mm in the maxilla only group and 3.6 mm in the bimaxillary group, with a mean horizontal relapse of 0.8 mm and 0.2 mm, respectively. Mean surgical movement in the vertical dimension was comparable in the two groups and the magnitude of vertical relapse was less than 0.4 mm overall. Approximately 80% of patients in both groups experienced horizontal relapse of less than 2 mm. There was no significant difference in the degree of postoperative relapse between those who had single-jaw surgery and those who had two-jaw surgery.