One-stage closure of isolated cleft palate with the Veau-Wardill-Kilner V to Y pushback procedure or the Cronin modification: III. Comparison of lateral craniofacial morphology

Relationships between the width of the palatal cleft measured at paIatopIasty and the craniofacial morphology or the occlusal conditions present at approximately 4 years of age were studied in 25 cleft palate (CP) and 39 complete unilateral cleft lip and palate (UCLP) subjects treated at the Dental Clinic of Kyushu University. Posteroanterior cephalograms and dental casts showed that the width of the palatal cleft was significantly correlated with wider upper facial width and posterior dental arch width in UCLP, but not in CP subjects. Cleft width was not significantly correlated with the buccolingual occlusal relationship in either subject type. The anterior occlusal relationship in UCLP was not as good as in CP subjects. On lateral cephalograms, the width of the palatal cleft was significantly correlated with vertical hypoplasia of the upper face in UCLP, but not in CP subjects. The cleft palate width appears to be related to the lateral displacement and the retardation of the downward and forward growth of the nasomaxillary complex in UCLP subjects.

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Facial growth in patients with isolated cleft palate treated with minimal incision technique compared to a normal population—a cephalometric study at 10 and 16 years of age

European Journal of Orthodontics ◽

10.1093/ejo/cjz082 ◽

2019 ◽

Author(s):

Konstantinos Parikakis ◽

Ola Larson ◽

Agneta Karsten

Keyword(s):

Cleft Palate ◽

Normal Population ◽

Treated Group ◽

Craniofacial Morphology ◽

Control Group ◽

Facial Growth ◽

Minimal Incision ◽

Lateral Cephalograms ◽

Incision Technique ◽

Isolated Cleft Palate

Summary Objective To evaluate the result of a novel palatoplasty (minimal incision technique) for closure of an isolated cleft palate (ICP) at 10 and 16 years of age, concerning facial growth, compared to a normal population. Subjects Treated group: 55 non-syndromic Caucasian children born with an ICP between 1987 and 2001. The children were treated surgically with a one-stage palatoplasty at a mean age of 13 months. Control group: 110 Caucasian children with normal occlusion with no history of clefts or orthodontic intervention. Method The treated children (25 boys, 30 girls) were matched (gender and age) with the children in the control group. A retrospective evaluation at 10 (mean 10.5) and 16 (mean 16.0) years of age was performed by analysis of lateral cephalograms. Fifteen variables were evaluated. Ninety-nine per cent confidence intervals were calculated. Two-way factorial ANOVA and mixed-model analysis were performed. Results Treated patients compared to the control group showed: at 10 years of age, smaller mandible (P = 0.001) and reduced posterior upper and total face heights (P ≤ 0.001); at 10 and 16 years of age, a retrognathic (P ≤ 0.001), smaller (P ≤ 0.006) and with an increased posterior inclination of the maxilla (P < 0.001), as well as a retrognathic mandible (P ≤ 0.006). Conclusion The craniofacial morphology at 10 and 16 years of age in patients born with an ICP and treated with the minimal incision technique differs compared to the morphology of a normal control group born without a cleft. Retrognathic maxillas and a smaller and posteriorly inclined maxilla were found in the treated group.

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