212 posters, 10 topics, 5 sessions, 754 authors, 237 institutions
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The AAPS 101st Annual Meeting
29 April – 2 May, 2023 | Chicago, IL
D48
Comparison Of Furlow And Straight-line Repair Techniques On Transverse Dental Arch Dimensions And Extent Of Orthodontic Intervention
Poster Presenter
Authors
Collean Trotter, BA, MAT, Sarah Alfeerawi, BS, MS, Dylan G. Choi, BS, Idean Roohani, BS, Pasha Shakoori, MD, DDS, MS, Artur Fahradyan, MD, Jessica A. Lee, MD, William P. Magee III, MD, DDS, Mark M. Urata, MD, DDS, Jeffrey A. Hammoudeh, MD, DDS
Affiliations
Children's Hospital Los Angeles, Division of Plastic and Reconstructive Surgery, Keck School of Medicine, Keck School of Medicine of the University of Southern California, Division of Plastic and Maxillofacial Surgery, Children’s Hospital Los Angeles,
Part of Topic
Craniofacial/Peds
Background
●Cleft lip and palate requires up to 9 operations for full correction
●Surgical intervention is associated with risk of midface hypoplasia
●Midface hypoplasia is associated with malocclusion, need for orthognathic surgery, maxillary dental arch abnormalities, anterior crossbite and lingual inclination of premolars
Objective
●This study aimed to identify the effect of the soft palate repair technique on the transverse dimensions of the maxillary dental arch and the extent of orthodontic interventions
Methods
●IRB-approved retrospective review of pediatric patients undergoing palatoplasty( 2003-2022)
●Patients with submucous and atypical Tessier clefts or index operations at an outside institution were excluded
●Primary Outcomes à maxillary narrowing, crossbites, transverse palatal expansion (TPE)
●Compared patients undergoing Straight line repair (SLR) to Furlow
Results
●1552 patients underwent palatoplasty, of which 833 met inclusion criteria
●417 SLR, 416 Furlow Repair
●39% of patients had Veau III anomalies (Figure 1)
●Of patients with Veau III anomalies, patients undergoing Furlow repairs had higher rates of maxillary narrowing, TPE and bilateral crossbites (Table 1)
●Logistic regression demonstrated Furlow palatoplasty as the only significant contributor to risk of TPE after adjusting for surgeon, age, gender, syndromic status and vomer flap utilization (Odds Ratio: 4.2, 95% Confidence Interval (1.477-12.226, p=0.001)
Conclusion
●Among Veau III clefts, Furlow repairs were associated with higher rates of maxillary dental arch narrowing and palatal expansion
●Furlow palatoplasty was the only significant contributing factor to risk of TPE
●Furlow repairs lengthen the soft palate at the extent of width
●Our results suggest this transverse deficit may extends to the maxillary dental arch