Early Orthodontic Intervention in Cleft Lip-Palate and Noncleft Children with Developing Class III Malocclusion: A Clinical Study.

Abstract

Orthopedic correction of skeletal class III malocclusion in a growing patient is crucial as it can circumvent future surgical procedures. The aim of the study is to evaluate the dental and skeletal effects of early orthodontic intervention of developing class III malocclusion. A final sample of 38 children in the age-group of 6-14 years having skeletal class III malocclusion was selected. Subjects were divided into two groups; group I-included 18 children (male-10, female-8) with surgically repaired cleft lip and palate and group II-20 children (male-14, female-6) without any cleft lip and palate. Cemented rapid maxillary expansion (RME) appliances with 11 mm hyrax screws were used in all patients. Elastic traction forces were applied to the reverse-pull headgear worn by the patients. Both pre- and posttreatment records along with lateral cephalograms were taken. The pre- and posttreatment mean and standard deviation measurements of the angular and linear observations were statistically analyzed with Statistical Package for the Social Sciences (SPSS) software (version 13) and were correlated through independent t-test and paired t-test. Following headgear therapy, improvement was greater in the cleft group than noncleft group with greater advancement of maxilla along with clockwise rotation of mandible in clefts. Protraction mechanics with expansion can be employed successfully in repaired cleft lip and palate and noncleft prepubertal children having developing class III malocclusion, showing concave profile, and retrusive maxilla. Accurate diagnosis and understanding of the individual growth pattern are crucial in the early interception of a class III malocclusion to achieve a more favorable facial profile. Sahoo SS, Dash JK, Sahoo PK, et al. Early Orthodontic Intervention in Cleft Lip-Palate and Noncleft Children with Developing Class III Malocclusion: A Clinical Study. Int J Clin Pediatr Dent 2023;16(5):716-723.