{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T03:35:34Z","timestamp":1790134534631,"version":"4.0.1"},"reference-count":24,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2024,2,26]],"date-time":"2024-02-26T00:00:00Z","timestamp":1708905600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Maxillary hypoplasia and mandibular asymmetry may be corrected with orthognathic surgery after growth completion. For most stable results, some cases may require segmental Le Fort I osteotomies. Unfortunately, Invisalign\u2019s software (6.0 version) still has some inherent limitations in predicting outcomes for complex surgeries. This study explores the potential of aligners, particularly in multiple-piece maxillary osteotomies in both cleft and non-cleft patients. Method: Thirteen patients who underwent pre-surgical treatment with Invisalign were retrospectively matched in terms of diagnosis, surgical procedure, and orthodontic complexity with thirteen patients treated using fixed appliances. Virtual curves following the lower arch were employed to guide the correct pre-surgical positions of the upper teeth with a simple superimposition technique. The amount of impressions required in both groups to achieve satisfactory pre-surgical alignment of the segmented arches was compared. Results: one or no refinement phases were needed in the Invisalign group to reach an acceptable pre-surgical occlusion, while the amount of pre-surgical impressions needed to reach adequate coordination with fixed appliance treatment was slightly higher (p &gt; 0.05). Conclusions: it appears that clear aligner could serve as an effective treatment for individuals necessitating segmental Le Fort I osteotomies when aided by the suggested simple superimposition approach.<\/jats:p>","DOI":"10.3390\/jcm13051329","type":"journal-article","created":{"date-parts":[[2024,2,26]],"date-time":"2024-02-26T10:40:17Z","timestamp":1708944017000},"page":"1329","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The Use of Clear Aligners in Multi-Segmental Maxillary Surgery: A Case\u2013Control Study in Cleft Lip and Palate and Skeletal Class III Patients"],"prefix":"10.3390","volume":"13","author":[{"given":"Maria Costanza","family":"Meazzini","sequence":"first","affiliation":[{"name":"Regional Center of Cleft Lip and Palate, Department of Maxillo Facial Surgery, Santi Paolo and Carlo Hospital, Via di Rudin\u00ec 8, 20142 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-6784-0975","authenticated-orcid":false,"given":"Leonardo Paolo","family":"Demonte","sequence":"additional","affiliation":[{"name":"Regional Center of Cleft Lip and Palate, Department of Maxillo Facial Surgery, Santi Paolo and Carlo Hospital, Via di Rudin\u00ec 8, 20142 Milan, Italy"},{"name":"Department of Orthodontics, University Vita-Salute, San Raffaele Hospital, 20132 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noah","family":"Cohen","sequence":"additional","affiliation":[{"name":"Regional Center of Cleft Lip and Palate, Department of Maxillo Facial Surgery, Santi Paolo and Carlo Hospital, Via di Rudin\u00ec 8, 20142 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria Marinella Augusta","family":"Battista","sequence":"additional","affiliation":[{"name":"Regional Center of Cleft Lip and Palate, Department of Maxillo Facial Surgery, Santi Paolo and Carlo Hospital, Via di Rudin\u00ec 8, 20142 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitri","family":"Rabbiosi","sequence":"additional","affiliation":[{"name":"Regional Center of Cleft Lip and Palate, Department of Maxillo Facial Surgery, Santi Paolo and Carlo Hospital, Via di Rudin\u00ec 8, 20142 Milan, Italy"},{"name":"Universit\u00e0 degli Studi dell\u2019Insubria, Circolo and Fondazione Macchi Hospital, 21100 Varese, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Autelitano","sequence":"additional","affiliation":[{"name":"Regional Center of Cleft Lip and Palate, Department of Maxillo Facial Surgery, Santi Paolo and Carlo Hospital, Via di Rudin\u00ec 8, 20142 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,2,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"982","DOI":"10.1007\/s00266-019-01371-z","article-title":"The Soft Tissue Angular Analysis of Facial Profile in Unoperated Adult Patients with Unilateral Cleft Palate","volume":"43","author":"Lin","year":"2019","journal-title":"Aesthetic Plast. Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1597\/15-280","article-title":"Cone Beam Computed Tomographic Evaluation of Mandibular Asymmetry in Patients with Cleft Lip and Palate","volume":"55","author":"Paknahad","year":"2018","journal-title":"Cleft Palate-Craniofacial J."},{"key":"ref_3","unstructured":"Wassmund, M. (1927). Frakturen und Luxationen des Gesichtssch\u00e4dels unter Ber\u00fccksichtigung der Komplikationen des Hirnsch\u00e4dels. Ihre Klinik und Therapie, Meusser."},{"key":"ref_4","unstructured":"Moorhead, A., and Serra, M. (2024). Le Fort Osteotomy, StatPearls Publishing."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"688","DOI":"10.1597\/12-211","article-title":"Long-Term Follow-Up of UCLP Patients: Surgical and Orthodontic Burden of Care during Growth and Final Orthognathic Surgery Need","volume":"52","author":"Meazzini","year":"2015","journal-title":"Cleft Palate-Craniofacial J."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1016\/j.ijom.2017.09.003","article-title":"Orthodontic camouflage versus orthodontic-orthognathic surgical treatment in class II malocclusion: A systematic review and meta-analysis","volume":"47","author":"Raposo","year":"2018","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"63","DOI":"10.4041\/kjod.2018.48.1.63","article-title":"Evaluation of the stability of maxillary expansion using cone-beam computed tomography after segmental Le Fort I osteotomy in adult patients with skeletal Class III malocclusion","volume":"48","author":"Kim","year":"2018","journal-title":"Korean J. Orthod."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1597\/06-218.1","article-title":"Prevalence of Abnormalities in Dental Structure, Position, and Eruption Pattern in a Population of Unilateral and Bilateral Cleft Lip and Palate Patients","volume":"45","author":"Tortora","year":"2008","journal-title":"Cleft Palate-Craniofacial J."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"666","DOI":"10.1016\/0278-2391(92)90092-E","article-title":"Modification of the maxillary Le Fort I osteotomy in cleft-orthognathic surgery: The unilateral cleft lip and palate deformity","volume":"50","author":"Posnick","year":"1992","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1459","DOI":"10.1097\/SCS.0000000000006456","article-title":"Technical Modifications Specific to the Cleft Le Fort I Osteotomy","volume":"31","author":"Susarla","year":"2020","journal-title":"J. Craniofacial Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"197","DOI":"10.17219\/dmp\/90989","article-title":"Methods of accelerating orthodontic tooth movement: A review of contemporary literature","volume":"55","author":"Kacprzak","year":"2018","journal-title":"Dent. Med. Probl."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1093\/ejo\/cjq069","article-title":"Social perceptions of adults wearing orthodontic appliances: A cross-sectional study","volume":"33","author":"Jeremiah","year":"2010","journal-title":"Eur. J. Orthod."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1177\/1055665619861780","article-title":"Comparison of Pain Perception in Patients Affected by Cleft and Cranio Facial Anomalies Treated with Traditional Fixed Appliances or Invisalign","volume":"57","author":"Meazzini","year":"2019","journal-title":"Cleft Palate-Craniofacial J."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1320","DOI":"10.1177\/1055665620947626","article-title":"Effect of Maxillary Osteotomy on Speech in Cleft Lip and Palate: Instrumental Outcomes of Velopharyngeal Function","volume":"57","author":"Pereira","year":"2020","journal-title":"Cleft Palate-Craniofacial J."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"431","DOI":"10.2319\/123121-959.1","article-title":"Combined orthodontic and surgical open bite correction: Principles for success. Part 2","volume":"92","author":"Arnett","year":"2022","journal-title":"Angle Orthod."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1422","DOI":"10.1016\/j.joms.2016.01.051","article-title":"Segmental Maxillary Osteotomies in Conjunction with Bimaxillary Orthognathic Surgery: Indications\u2014Safety\u2014Outcome","volume":"74","author":"Posnick","year":"2016","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Retrouvey, J.M., and Abdallah, M.N. (2021). 3D Diagnosis and Treatment Planning in Orthodontics, Springer.","DOI":"10.1007\/978-3-030-57223-5"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1488","DOI":"10.1097\/SCS.0000000000005572","article-title":"Comparing Outcomes in Orthognathic Surgery Using Clear Aligners versus Conventional Fixed Appliances","volume":"30","author":"Kankam","year":"2019","journal-title":"J. Craniofacial Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"140","DOI":"10.4041\/kjod.2019.49.3.140","article-title":"A systematic review of the accuracy and efficiency of dental movements with Invisalign\u00ae","volume":"49","author":"Plasencia","year":"2019","journal-title":"Korean J. Orthod."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"229","DOI":"10.5152\/TurkJOrthod.2019.19019","article-title":"Comparative Assessment of Clinical and Predicted Treatment Outcomes of Clear Aligner Treatment: An In Vivo Study","volume":"32","author":"Izhar","year":"2019","journal-title":"Turk. J. Orthod."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1016\/j.ajodo.2021.12.019","article-title":"Presurgical orthodontic decompensation with clear aligners","volume":"162","author":"Cong","year":"2022","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1016\/j.xaor.2022.03.001","article-title":"Considerations for treatment of patients undergoing orthognathic surgery using clear aligners","volume":"2","author":"Moshiri","year":"2022","journal-title":"AJO-DO Clin. Companion"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"997","DOI":"10.1016\/S0278-2391(10)80043-6","article-title":"Masticatory Function in Patients with Mandibular Prognathism before and After Orthognathic Surgery","volume":"51","author":"Kobayashi","year":"1993","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Bollato, B., Barone, M., Gracco, A., Baciliero, U., Crivellin, G., Bruno, G., and De Stefani, A. (2022). The Accuracy of Jaws Repositioning in Bimaxillary Orthognathic Surgery in Patients with Cleft Lip and Palate Compared to Non-Syndromic Skeletal Class III Patients. J. Clin. Med., 11.","DOI":"10.3390\/jcm11092675"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/5\/1329\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:05:15Z","timestamp":1760105115000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/5\/1329"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,26]]},"references-count":24,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2024,3]]}},"alternative-id":["jcm13051329"],"URL":"https:\/\/doi.org\/10.3390\/jcm13051329","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,26]]}}}