{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T01:08:29Z","timestamp":1785805709844,"version":"3.56.0"},"reference-count":56,"publisher":"The Angle Orthodontist (EH Angle Education & Research Foundation)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    <jats:bold>Objective:<\/jats:bold>\n                    \u2002To evaluate early and late velopharyngeal changes in cleft lip and palate (CLP) patients after use of the Rigid External Distractor (RED) device and to correlate these changes to the amount of maxillary advancement.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Materials and Methods:<\/jats:bold>\n                    \u2002Thirty Class III CLP patients were included in the study. Maxillary advancement was performed using the RED device in combination with titanium miniplates and screws for anchorage. Lateral cephalograms, nasometer, and nasopharyngoscope records were taken before distraction, immediately after distraction, and 1 year after distraction. A paired\n                    <jats:italic>t<\/jats:italic>\n                    -test was used to detect differences at\n                    <jats:italic>P<\/jats:italic>\n                    &lt; .05.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results:<\/jats:bold>\n                    \u2002SNA angle and A point and ANS to Y axis were significantly increased after maxillary distraction (\n                    <jats:italic>P<\/jats:italic>\n                    \u200a=\u200a .0001). Statistically significant increases in nasopharyngeal and oropharyngeal depths, velar angle, and need ratio were also found (\n                    <jats:italic>P<\/jats:italic>\n                    \u200a=\u200a .0001). Nasalance scores showed a significant increase (\n                    <jats:italic>P<\/jats:italic>\n                    \u200a=\u200a .008 for nasal text and .044 for oral text). A significant positive correlation was observed between the amount of maxillary advancement and the increase in nasopharyngeal depth and hypernasality (\n                    <jats:italic>P<\/jats:italic>\n                    \u200a=\u200a .012 and .026, respectively).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusions:<\/jats:bold>\n                    \u2002Nasopharyngeal function was deteriorated after maxillary advancement in CLP patients. There was a significant positive correlation between the amount of maxillary advancement and the increase in nasopharyngeal depth and hypernasality.\n                  <\/jats:p>","DOI":"10.2319\/011216-33.1","type":"journal-article","created":{"date-parts":[[2016,3,23]],"date-time":"2016-03-23T11:51:13Z","timestamp":1458733873000},"page":"962-968","source":"Crossref","is-referenced-by-count":14,"title":["Velopharyngeal changes after maxillary distraction in cleft patients using a rigid external distraction device: A retrospective study"],"prefix":"10.2319","volume":"86","author":[{"given":"Mahasen","family":"Taha","sequence":"first","affiliation":[{"name":"Associate Professor, Orthodontic Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasser M.","family":"Elsheikh","sequence":"additional","affiliation":[{"name":"Assistant Professor of Plastic Surgery, Faculty of Medicine, Menuofyia University, Menuofyia, Egypt."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1164","reference":[{"key":"i0003-3219-86-6-962-r1","series-title":"Cleft Palate Craniofac J","first-page":"471","article-title":"Maxillary arch dimensions in normal and unilateral cleft lip and palate subjects","volume":"6","author":"Huddart\n              AG.","year":"1969","unstructured":"Huddart\n              AG. \n          \n          Maxillary arch dimensions in normal and unilateral cleft lip and palate subjects. Cleft Palate Craniofac J. 1969;6:471\u2013487."},{"key":"i0003-3219-86-6-962-r2","series-title":"Cleft Palate J","first-page":"54","article-title":"Treatment variables affecting facial growth in unilateral cleft lip and palate: part 5. Timing of palate repair","volume":"24","author":"Ross\n              RB.","year":"1987","unstructured":"Ross\n              RB. \n          \n          Treatment variables affecting facial growth in unilateral cleft lip and palate: part 5. Timing of palate repair. Cleft Palate J. 1987;24:54\u201356."},{"key":"i0003-3219-86-6-962-r3","article-title":"Orthognathic Defects and Surgical Correction: The Effect on Speech and Velopharyngeal Function [Doctoral dissertation]","author":"Witzel\n              MA.","year":"1981","unstructured":"Witzel\n              MA. \n          \n          Orthognathic Defects and Surgical Correction: The Effect on Speech and Velopharyngeal Function [Doctoral dissertation]. Pittsburgh, Pa: University of Pittsburgh; 1981."},{"key":"i0003-3219-86-6-962-r4","series-title":"Folia Phoniatr Logop","first-page":"42","article-title":"Velopharyngeal function in cleft patients undergoing maxillary advancement","volume":"49","author":"Haapanen\n              ML,","year":"1997","unstructured":"Haapanen\n              ML, \n            \n              Kalland\n              M, \n            \n              Heliovaara\n              A. \n          \n          Velopharyngeal function in cleft patients undergoing maxillary advancement. 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Cleft Palate J. 1977;14:176\u2013180."},{"key":"i0003-3219-86-6-962-r7","series-title":"Cleft Palate Craniofac J","first-page":"54","article-title":"Effects of orthognathic surgery on speech and breathing of subjects with cleft lip and palate: acoustic and aerodynamic assessment","volume":"40","author":"Trindade\n              IE,","year":"2003","unstructured":"Trindade\n              IE, \n            \n              Yamashita\n              RP, \n            \n              Suguimoto\n              RM, \n            \n              Mazzottini\n              R, \n            \n              Trindade\n              IE. \n          \n          Effects of orthognathic surgery on speech and breathing of subjects with cleft lip and palate: acoustic and aerodynamic assessment. Cleft Palate Craniofac J. 2003;40:54\u201364."},{"key":"i0003-3219-86-6-962-r8","series-title":"J Craniofac Surg","first-page":"330","article-title":"Pharyngoplasty in patients with cleft lip and palate after maxillary advancement","volume":"9","author":"Maegawa\n              J,","year":"1998","unstructured":"Maegawa\n              J, \n            \n              Sells\n              RK, \n            \n              David\n              DJ. \n          \n          Pharyngoplasty in patients with cleft lip and palate after maxillary advancement. 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Cleft Palate Craniofac J. 2007;44:274\u2013277."},{"key":"i0003-3219-86-6-962-r12","series-title":"Angle Orthod","first-page":"602","article-title":"Use of distraction osteogenesis in cleft palate patients","volume":"73","author":"Tae\n              KC,","year":"2003","unstructured":"Tae\n              KC, \n            \n              Gong\n              SG, \n            \n              Min\n              SK, \n            \n              Oh\n              SW. \n          \n          Use of distraction osteogenesis in cleft palate patients. Angle Orthod. 2003;73:602\u2013607."},{"key":"i0003-3219-86-6-962-r13","series-title":"Plast Reconstr Surg","first-page":"951","article-title":"Maxillary distraction: aesthetic and functional benefits in cleft lip-palate and prognathic patients during mixed dentition","volume":"101","author":"Molina\n              F,","year":"1998","unstructured":"Molina\n              F, \n            \n              Ortiz Monasterio\n              F, \n            \n              de la Paz Aguilar\n              M, \n            \n              Barrera\n              J. \n          \n          Maxillary distraction: aesthetic and functional benefits in cleft lip-palate and prognathic patients during mixed dentition. Plast Reconstr Surg. 1998;101:951\u2013963."},{"key":"i0003-3219-86-6-962-r14","series-title":"J Craniofac Surg","first-page":"312","article-title":"Velopharyngeal changes after maxillary advancement in cleft patients with distraction osteogenesis using a rigid external distraction device: a 1-year cephalometric follow-up","volume":"10","author":"Ko\n              EW,","year":"1999","unstructured":"Ko\n              EW, \n            \n              Figueroa\n              AA, \n            \n              Guyette\n              TW, \n            \n              Polley\n              JW, \n            \n              Law\n              WR. \n          \n          Velopharyngeal changes after maxillary advancement in cleft patients with distraction osteogenesis using a rigid external distraction device: a 1-year cephalometric follow-up. J Craniofac Surg. 1999;10:312\u2013320."},{"key":"i0003-3219-86-6-962-r15","series-title":"Cleft Palate Craniofac J","first-page":"199","article-title":"Changes in speech following maxillary distraction osteogenesis","volume":"38","author":"Guyette\n              TW,","year":"2001","unstructured":"Guyette\n              TW, \n            \n              Polley\n              JW, \n            \n              Figueroa\n              A, \n            \n              Smith\n              BE. \n          \n          Changes in speech following maxillary distraction osteogenesis. Cleft Palate Craniofac J. 2001;38:199\u2013205."},{"key":"i0003-3219-86-6-962-r16","series-title":"Oral Surg Oral Med Oral Pathol Oral Radiol Endod","first-page":"538","article-title":"Effect of maxillary distraction osteogenesis on velopharyngeal function: a pilot study","volume":"93","author":"Harada\n              K,","year":"2002","unstructured":"Harada\n              K, \n            \n              Ishii\n              Y, \n            \n              Ishii\n              M, \n            \n              Imaizumi\n              H, \n            \n              Mibu\n              M, \n            \n              Omura\n              K. \n          \n          Effect of maxillary distraction osteogenesis on velopharyngeal function: a pilot study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;93:538\u2013543."},{"key":"i0003-3219-86-6-962-r17","series-title":"Cleft Palate Craniofac J","first-page":"355","article-title":"Morphological evaluation of changes in velopharyngeal function following maxillary distraction in patients with repaired cleft palate during mixed dentition","volume":"41","author":"Satoh\n              K,","year":"2004","unstructured":"Satoh\n              K, \n            \n              Nagata\n              J, \n            \n              Shonura\n              K, \n            \n              Wada\n              T, \n            \n              Fukuda\n              J, \n            \n              Shiba\n              R. \n          \n          Morphological evaluation of changes in velopharyngeal function following maxillary distraction in patients with repaired cleft palate during mixed dentition. Cleft Palate Craniofac J. 2004;41:355\u2013363."},{"key":"i0003-3219-86-6-962-r18","series-title":"Angle Orthod","first-page":"853","article-title":"First premolar extraction effects on upper airway dimension in bimaxillary proclination patients","volume":"82","author":"Al Maaitah\n              E,","year":"2012","unstructured":"Al Maaitah\n              E, \n            \n              El Said\n              N, \n            \n              Abu\n              AL, \n            \n              Haija\n              E, \n            \n              H\u00e4ggd\n              U. \n          \n          First premolar extraction effects on upper airway dimension in bimaxillary proclination patients. Angle Orthod. 2012;82:853\u2013859."},{"key":"i0003-3219-86-6-962-r19","series-title":"Statistical Methods for Medical and Biological Students","author":"Dahlberg\n              G","year":"1940","unstructured":"Dahlberg\n              G\n            \n          . 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Pittsburgh, Pa: University of Pittsburgh; 1981."},{"key":"i0003-3219-86-6-962-r4","series-title":"Folia Phoniatr Logop","first-page":"42","article-title":"Velopharyngeal function in cleft patients undergoing maxillary advancement","volume":"49","author":"Haapanen\n              ML,","year":"1997","unstructured":"Haapanen\n              ML, \n            \n              Kalland\n              M, \n            \n              Heliovaara\n              A. \n          \n          Velopharyngeal function in cleft patients undergoing maxillary advancement. 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Cleft Palate Craniofac J. 2007;44:274\u2013277."},{"key":"i0003-3219-86-6-962-r12","series-title":"Angle Orthod","first-page":"602","article-title":"Use of distraction osteogenesis in cleft palate patients","volume":"73","author":"Tae\n              KC,","year":"2003","unstructured":"Tae\n              KC, \n            \n              Gong\n              SG, \n            \n              Min\n              SK, \n            \n              Oh\n              SW. \n          \n          Use of distraction osteogenesis in cleft palate patients. 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Plast Reconstr Surg. 1998;101:951\u2013963."},{"key":"i0003-3219-86-6-962-r14","series-title":"J Craniofac Surg","first-page":"312","article-title":"Velopharyngeal changes after maxillary advancement in cleft patients with distraction osteogenesis using a rigid external distraction device: a 1-year cephalometric follow-up","volume":"10","author":"Ko\n              EW,","year":"1999","unstructured":"Ko\n              EW, \n            \n              Figueroa\n              AA, \n            \n              Guyette\n              TW, \n            \n              Polley\n              JW, \n            \n              Law\n              WR. \n          \n          Velopharyngeal changes after maxillary advancement in cleft patients with distraction osteogenesis using a rigid external distraction device: a 1-year cephalometric follow-up. 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