Abstract
BackgroundAlthough arch stability has been studied in patients without a cleft, evidence for patients with a cleft is sparse. Therefore, we compared the dimensions and stability of dental arches in cleft lip and palate patients and those without a cleft.MethodsForty participants, 20 with a complete unilateral cleft lip and palate and 20 non-cleft patients aged from 18 to 30 years, with anterior and/or posterior crossbite and receiving orthodontic treatment were evaluated retrospectively. Eighty gypsum casts were digitized using a laser model scanner casts for both groups made immediately after the orthodontic treatment was completed (T1). Also, for the Cleft Lip and Palate group, casts were obtained and digitized 1 year after implant-supported rehabilitation (T2) and for the Non-Cleft Lip and Palate group, 1 year after the conclusion of the orthodontic treatment (T2). The formula: Δ = T2-T1 evaluated the stability of dental arches for inter-canine distances (C-C′), inter-molar distances (M-M’), arch length (I-M), palate surface and volume. The dimensions of the dental arches were measured digitally. The independent t test was used for statistical analysis (α = 0.05).ResultsA statistical difference was found in the stability of the groups for inter-canine (cleft area) measurement. At the times T1 and T2, a statistically significant difference was found in the arch length, surface and volume.ConclusionsThis study concluded that in the Cleft Lip and Palate group, the maxillary dimensions were not stabilized after 1 year of orthodontic and prosthodontic treatment (mainly for the inter-canine linear measurement) and that the transverse arch dimensions were smaller compared with those of non-cleft patients.
Highlights
Arch stability has been studied in patients without a cleft, evidence for patients with a cleft is sparse
Rehabilitating the cleft area with osseointegrated dental implants rather than a fixed dental prosthesis is based on an implant survival rate of 90% at the cleft area [12], similar to that found in patients without a cleft [13]
Forty patients were selected from the 115 individuals evaluated and were divided in two groups: cleft lip and palate (CLP) group (n = 20) with complete unilateral cleft lip and palate who had received multidisciplinary treatment at the Hospital for Rehabilitation of Craniofacial Anomalies from birth, with primary surgeries, until the end of treatment when adult, with an implant placed in the cleft area; and the non-cleft group (NCLP), (n = 20)
Summary
Arch stability has been studied in patients without a cleft, evidence for patients with a cleft is sparse. We compared the dimensions and stability of dental arches in cleft lip and palate patients and those without a cleft. Patients with cleft lip and palate (CLP) are identified and typically treated with primary plastic surgeries (cheiloplasty and palatoplasty) usually performed before 12 months of age [2]. Despite rehabilitating esthetics and function, these primary surgeries result in a deleterious effect on maxillary growth [3, 4], with shorter antero-posterior dimension of the alveolar arch in unilateral CLP patients [5]. Obtaining ideal intermaxillary relationships and occlusion, as well as post-treatment stability, requires proper alignment of the teeth in both dental arches, with adequate overjet and overbite [9, 10]. Many patients require different types of dental prosthesis to rehabilitate the edentulous cleft area, typically the lateral incisor area [11]. Rehabilitating the cleft area with osseointegrated dental implants rather than a fixed dental prosthesis is based on an implant survival rate of 90% at the cleft area [12], similar to that found in patients without a cleft [13]
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