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

Objective: To investigate the soft tissue profile changes associated with L eFort maxillary osteotomy in subjects with cleft lip and palate and the pre dictability of those changes. Design: A retrospective cephalometric study. The sample comprises 28 patien ts with cleft lip and palate. All consecutively treated cases with satisfac tory records at Frenchay Hospital, Bristol, and St. Lawrence Hospital, Chep stow, were included. Results: Males and females showed no significant differences in their soft tissue response. The proportion of soft to hard tissue change increased pro gressively for points that are more inferiorly placed on the upper soft tis sue profile. The horizontal change in upper incisor position was the most c ommon significant predictor of soft tissue change but accounted for less th an 50% of the variability of change for all soft tissue points. The cleft l ip patients in this study did not have upper lips that were compressed as a result of the orthognathic surgery by a significantly different amount whe n compared with those of noncleft patients in previous studies. Conclusions: The soft tissue response to LeFort osteototomy is similar in a mount in cleft and noncleft subjects. Movement of the upper incisor tip is the best predictor of soft tissue changes, but the confidence limits of pre dictability are relatively wide.