Cephalometric Analysis of Hard and Soft Tissue Changes Following Anterior Maxillary Osteotomy Distraction in Cleft Maxillary Hypoplasia

Background Nonsyndromic unilateral CLAP patients despite the best surgical efforts present with variable degree of maxillary hypoplasia after cleft palate repair. AMOD is an extension of anterior maxillary osteotomy where the resulting segment anterior to the chosen site of vertical corticotomy cut is distracted with the help of hyrax screw through a tooth-borne appliance. Aims and Objectives To analyze the hard and soft tissue profile changes following AMOD. To determine the ratio of soft tissue changes to the given extent of hard tissue movements. Materials and Methods Study group consisted of 25 patients with cleft maxillary hypoplasia reporting to the Department of OMFS, Coorg Institute of Dental Science. The preoperative and postoperative radiographs were taken followed by prediction tracing. In comparison of pre-op and post-op ceph mean improvement in hard tissue profile was seen at N-A by 2.84 mm, N-A-Pg by 2.52, ANS-Gn by 2.28 mm, N-ANS by 0.68 mm, 1-Nf by 0.32 and at PNS-ANS was 4.2 mm signifying improvement in middle third of face. Mean improvement in soft tissue profile at G-Sn-Pg angle by 1.2, G-Sn was 3.92 mm, nasolabial angle by 10.92, incisor exposure (Stm-1) by 0.24 mm and interlabial gap by 0.56 mm. On ratio and correlation of soft tissue changes to given extent of hard tissue change, with movement of point A and U1 resulted significant changes in Sn and Ls. Movement of ANS resulted in significant changes in pronasale and columella. Conclusions In our study significant improvement was seen in hard and soft tissue facial profile. In conclusion, AMOD is one of the emerging techniques to correct cleft maxillary hypoplasia which will have a defined definitive role to play in future.