Horizontal Maxillary Osteotomy Stability Using Mandibular Outer Cortex Bone Grafts in Patients With Cleft Lip and Palate

Objective: To investigate horizontal maxillary osteotomy stability after using bone grafts for the treatment of patients with unilateral cleft lip and palate (UCLP). Design: Retrospective cohort study. Setting: Plastic surgery hospital. Patients: Fifty-eight patients with UCLP and maxillary hypoplasia requiring a maxillary Le Fort I advancement of 6 to 9 mm. Interventions: The test group (TG) was comprised of 28 patients who underwent mandibular outer cortex bone grafting in the gaps created by a modified Le Fort I osteotomy. The control group (CG) was comprised of 30 patients who underwent a Le Fort I osteotomy without bone grafts. Main Outcome Measures: Maxillary horizontal advancement (recorded during the operation using a Vernier caliper) and horizontal relapse at 12 months after surgery (based on a manual cephalometric analysis of pre- and postoperative lateral teleradiographs). Results: In the TG, the mean maxillary horizontal advancement was 7.13 +/- 0.7 mm (range: 6.01-8.23 mm), and the mean postoperative horizontal relapse was 25.07 +/- 6.64%. In the CG, the mean maxillary horizontal advancement was 6.90 +/- 0.55 mm (range: 6.05-7.39 mm), and the mean postoperative horizontal relapse was 24.89 +/- 4.25%. There were no significant between-group differences in the mean horizontal relapses. Conclusion: The use of mandibular outer cortex bone grafts as physical barriers in patients with UCLP does not increase postoperative stability when the maxillary advancement is 6 to 9 mm.