Soft tissue profile changes in patients with cleft lip and palate following maxillary osteotomies

Objective: To investigate the soft tissue profile changes associated with LeFort maxillary osteotomy in subjects with cleft lip and palate and the predictability of those changes. Design: A retrospective cephalometric study. The sample comprises 28 patients with cleft lip and palate. All consecutively treated cases with satisfactory records at Frenchay Hospital, Bristol, and St. Lawrence Hospital, Chepstow, were included. Results: Males and females showed no significant differences in their soft tissue response. The proportion of soft to hard tissue change increased progressively for points that are more inferiorly placed on the upper soft tissue profile. The horizontal change in upper incisor position was the most common significant predictor of soft tissue change but accounted for less than 50% of the variability of change for all soft tissue points. The cleft lip patients in this study did not have upper lips that were compressed as a result of the orthognathic surgery by a significantly different amount when compared with those of noncleft patients in previous studies. Conclusions: The soft tissue response to LeFort osteototomy is similar in amount in cleft and noncleft subjects. Movement of the upper incisor tip is the best predictor of soft tissue changes, but the confidence limits of predictability are relatively wide.