구순 - 치조열 파열환자에서 르포씨 1형 전진 - 전방 전진의 한계점

Le Fort I advancement in cleft patient - limitation of maximum advancement

Midfacial depression after cleft lip and palate surgery is one of the most common complications after cleft surgery. Scar contracture during growth periods limits further development of the maxilla. Typical treatment protocol is using orthognathic surgery usually by bi-jaw surgery. Maxillary advancement and mandibular setback surgery are most common procedures for correction of midfacial depression. Cleft patients usually present with normal mandibular growth. Mandibular setback surgery is not indicated for cleft patient with normal mandibular growth and development. In this case report, a 26-year-old cleft patient presented to correct maxillary depression and anterior cross bite. Maxillary overjet was -8mm after preoperative orthodontic treatment. At least 14 mm advancement was required to compensate postoperative relapse. Patient showed normal pattern of growth in the mandible. Patient reclined to receive distraction osteogenesis or mandibular setback surgery. Le Fort I advancement of 14mm was performed and fixed with miniplates with ramal bone graft. Postoperative relapse was 2mm in anterior-posterior direction.