Maxillary Advancement Osteotomy for Cleft Lip and Palate Sequelae: Impact of Orthodontic Space Closure of Missing Lateral Incisor on Morphologic and Occlusal Results

BackgroundMaxillary hypoplasia is a common sequela of cleft lip and palate (CLP), often requiring surgical correction through maxillary advancement osteotomy. However, the resulting aesthetic outcome can be unpredictable. Frequently, these cases involve maxillary lateral incisor agenesis, managed either by preserving the space for dental rehabilitation or through orthodontic space closure.PurposeTo investigate the correlation between aesthetic and occlusal outcomes and the management of the missing maxillary lateral incisor space. Secondary objectives included assessing the relationship between aesthetic and occlusal scores and space management, nasolabial angle, the extent of maxillary advancement, and the maxillary incisor axis.Study designRetrospective cohort study.Patients/participantsThis retrospective study analyzed 47 patients with CLP sequelae who underwent maxillary advancement surgery between 2008 and 2022 at our center.InterventionAesthetic evaluation and occlusal evaluation.Main outcome variablesAesthetic evaluation and occlusal evaluation were independently conducted by 5 examiners. Aesthetic and occlusal scores were deemed satisfactory if they exceeded ≥30 of 40 and 15 of 20, respectively. These outcomes were correlated with the preservation of the maxillary lateral incisor space, extent of maxillary advancement, nasolabial angle, and maxillary incisor axis.ResultsNo significant improvement in aesthetic or occlusal outcomes was observed, regardless of whether the maxillary lateral incisor space was preserved. However, space closure was associated with greater maxillary advancement (<i>P</i> = .025).Conclusions and relevanceOrthodontic space closure may lead to better outcomes. Further research involving larger sample sizes and consideration of additional factors is needed to determine the optimal approach for each patient.