Soft Tissue Changes after Maxillary Advancement in Patients with Cleft Lip and Palate

Objectives: The purpose of this retrospective observational study was to analyse the soft tissue response in patients with cleft lip and palate undergoing maxillary advancement and its correlation with hard tissue changes.

Material and Methods: A cephalometric analysis and comparison of pre- and postoperative lateral cephalometric radiographs was performed using Dolphin Imaging software (Dolphin Imaging & Management Solutions). A total of 261 lateral cephalometric radiographs (preoperative, immediate postoperative and 6 months postoperative) from 87 patients with cleft lip and palate who underwent maxillary advancement (Le Fort I osteotomy) were analysed. Maxillary advancement was measured and patients were categorized by advancement magnitude. Statistical analysis involved comparison of soft tissue changes across different advancement groups.

Results: Overall, significant increases were observed in overjet, overbite, upper lip length, and facial harmony, while nose size decreased. The highest soft/hard tissue ratios were observed with advancements ≤ 5.0 mm. Soft tissue changes were minimal for advancements ≤ 5.0 mm but more pronounced for larger advancements. No significant correlation was found between cephalometric variables and maxillary advancement.

Conclusions: Maxillary advancement significantly influences soft tissue changes in patients with cleft lip and palate. Smaller advancements result in minimal soft tissue changes, while larger advancements impact lip thickness and incisor exposure.

J Oral Maxillofac Res 2026;17(1):e5

doi: 10.5037/jomr.2026.17105

Accepted for publication: 24 January 2026

Keywords: cephalometry; cleft lip; cleft palate; LeFort Osteotomy; maxillary osteotomy; orthognathic surgery.