D48. Comparison of Furlow and Straight-line Repair Techniques on Transverse Dental Arch Dimensions and Extent of Orthodontic Intervention

Abstract

PURPOSE: The Furlow and straight-line repair are commonly performed palatoplasty techniques. The impact of palatoplasty technique on the transverse axis of the dental arch has yet to be explored. This study aims to compare the impact of palatoplasty techniques on the transverse palatal dimensions and the extent for postoperative orthodontic interventions. METHODS: A retrospective chart review of all patients with cleft palate at an urban academic institution between 1997-2022 was completed. Variables including cleft phenotype, repair type, and orthodontic evaluation and interventions were collected. Data were analyzed using Wilcoxon and Chi-Squared analyses in RStudio 4.2.1. RESULTS: 1,552 patients with cleft palate deformities, 53% underwent Furlow repair and 47% underwent straight line repair. Straight line repairs were associated with increased rates of orthodontist reported maxillary narrowing compared to Furlow (47% vs 33%, p=.013). Additionally, patients undergoing straight line repair demonstrated higher rates of orthodontic transverse palatal expansion compared to the Furlow cohort (45.88% vs 30.19%, p=.002). Sub-analysis demonstrated this relationship was only maintained in Veau IV clefts and not in Veau I-III, where the repair technique did not statistically affect rates of transverse palatal expansion. CONCLUSION: This data associates straight line repair with increased prevalence of maxillary narrowing and transverse palatal expansion, particularly in Veau IV cleft phenotypes. Independent of the soft palate repair technique, hard palate repair is relatively standardized. These results implicate the soft palate repair method may affect maxillary development and subsequent orthodontic needs in patients with bilateral cleft lip and palate.