Early Dimensional Changes in Maxillary Cleft Size and Arch Dimensions of Children with Cleft Lip and Palate and Cleft Palate

Abstract

Objective : To study early changes in cleft size and maxillary arch dimensions and to evaluate these changes in relation to performed surgical procedures. Design : Retrospective longitudinal study. Setting : The Cleft Lip and Palate Center, Uppsala University Hospital, Sweden. Patients : Dental study models of 79 consecutive children (28 with unilateral cleft lip and palate, 39 with cleft palate, and 12 with Pierre Robin sequence) were analyzed. Interventions : Lip repair at 3 to 4months, soft palate repair at 6 to 10months, and hard palate repair at 25 to 26months of age. Main Outcome Measures : Cleft size was measured before each surgical intervention up to 2years and arch dimensions were measured before each surgical intervention and at 5years. Results : Cleft widths decreased from infancy up to 2years, but the anteroposterior cleft length in cleft palate was unchanged. Arch widths between cuspid points (C-C1) and tuberosity points (T-T1) and also the change over time in C-C1 and T-T1 differed significantly between the groups from infancy up to 5years. Conclusions : Cleft widths decreased after lip closure and/or soft palate closure. The children with unilateral cleft lip and palate had wider maxillary arch dimensions than the children with cleft palate or Pierre Robin sequence during the first years of life, but after hard palate closure the transverse growth was reduced in the children with unilateral cleft lip and palate. At 5years the children with unilateral cleft lip and palate had similar maxillary widths as the children with cleft palate and/or Pierre Robin sequence.