PROTRAÇÃO MAXILAR ORTOPÉDICA EM PACIENTES EM CRESCIMENTO COM FISSURA BILATERAL: REVISÃO INTEGRATIVA DA LITERATURA

Abstract

The therapeutic management of patients with cleft lip and palate is challenging, and complete bilateral clefts are the most difficult to treat. These patients have a growth deficit related to early reconstructive procedures. This study aimed to review the literature on maxillary protraction protocols and their effects in growing patients with bilateral cleft lip and palate. The PubMed, ScienceDirect, Cochrane Library, and Virtual Health Library, and Scopus databases were searched using keywords “maxillary protraction”, “bilateral cleft”, and “orthodontic” combined with the Boolean operator “AND”. In total, three protocols for protraction in patients with bilateral cleft lip and palate are reported: face mask protraction with dental anchorage, face mask protraction with skeletal anchorage, and intermaxillary traction with skeletal anchorage. The results suggest that dental and skeletal anchorage protraction therapies effectively treat patients with maxillary hypoplasia, although the specific effects vary according to treatment protocol, type of anchorage, and factors related to cleftseverity and surgical history. Orthopedic protraction of the maxilla has positive aesthetic, skeletal, and functional effects. Early treatment and the use of skeletal anchorages enhance these effects. Large studies are needed to determine the best protocol for optimal results.