RESUMEN
AIM: To assess treatment outcome and 1-year stability of LeFort I advancement in patients with complete cleft lip and palate. METHODS: Thirty-five patients (age 20.65â±â2.20âyears) with unilateral (nâ=â25) or bilateral (nâ=â10) complete cleft lip and palate who underwent LeFort I advancement were included.Lateral cephalograms before surgery (T1), immediately postsurgery (T2), and at 1-year follow-up (T3) were superimposed, and the position of anterior nasal spine (ANS), A-point, and U1 Tip assessed using an x, y coordinate system. Differences between landmark positions at the 3-time points were analyzed using paired sample t-tests, with a significance defined as α ≤ 0.05. RESULTS: The mean surgical advancement in the horizontal direction (T2-T1) was 6.50â±â2.62âmm at ANS (Pâ<â0.001) and 7.05â±â2.51âmm at A-point (Pâ<â0.001). At a 1-year follow-up (T3-T2), the mean horizontal relapse at ANS was -1.41â±â1.89âmm (Pâ<â0.001) and -0.79â±â1.48âmm at A-point (P 0.003). Mean horizontal relapse was 21.7% and 11% of surgical advancement when assessed at ANS and A-point, respectively. The central incisor tip position remained stable during the postsurgical period (0.12â±â2.11âmm, P 0.732). At A-point, the mean vertical surgical change (T2-T1) was -0.96â±â2.57âmm (Pâ<â0.001). No significant post-treatment (T3-T2) vertical changes were detected at ANS or A-point. Phenotypic stability was excellent, with all patients maintaining positive overjet at 1-year follow-up. CONCLUSIONS: LeFort I advancement in complete cleft lip and palate is stable, with less than a 2âmm relapse after 1-year. Surgical overcorrection by 10% to 20% is recommended to compensate for the expected skeletal relapse.