Late maxillary protraction compared with orthognathic surgery

Objectives:To compare the cephalometric outcomes between late maxillary protraction and orthognathic surgery Methods: Patients with cleft lip and palate and a Cl III malocclusion were treated either at age 13(n=14) with sutural loosening and maxillary protraction, or at age 17-19 with orthognathic surgery(n=14). Four cephalometric radiographs included pre-treatment, maximum protraction, 3-6 months post-protraction and one year following orthdontic retention. Similar radiographs were taken for the surgery group. The xrays were digitized on Dolphin imaging software and compared for soft tissue,occlusal plane, bony and dental measurements. Results: Maxillary protraction corrected the Cl III underbite and produced favorable soft tissue profiles. Multiple mechanisms contributed to the correction. Orthognathic surgery had a higher rate of relapse one year after debanding. Conclusions:Late maxillary protraction can be used to correct 3- 8 mm Cl III malocclusions.