Effect of timing and method of closure of isolated cleft palate on development of dental arches from 3 to 6 years of age.

Abstract

Development of the dental arches from 3 to 6 years of age was followed in 120 children with isolated cleft palate (ICP) and in 50 non-cleft (NONC) children. In 60 of the ICP children the palate had been repaired at the age of 1.8 years (SD = 0.2) and in the other 60 at the age of 1.1 years (SD = 0.1). In both groups the one-stage soft and hard cleft palate closure had been performed using the mucoperiosteal palatal V to Y push-back technique (Veau-Wardill-Kilner) or the Cronin modification. The purpose of this study was to compare the effect of the two different ages and the two different methods of palatal repair on the development of dental arches. The growth increment in maxillary canine and molar width, and posterior palatal height during the 3-year period was greater in the group with late palatal repair. In children with no secondary palatal repair, when the primary repair had been done with the V to Y method, the increase in maxillary canine width was greater than with the Cronin modification. On the other hand, when the V to Y technique was used, velopharyngoplasties were more frequent. The means of maxillary canine and molar width decreased in children with velopharyngoplasties, and increased in the others. Dental arches of ICP children were significantly smaller than those of NONC children, and the discrepancy increased during the period from 3 to 6 years of age, and increased more in the maxilla than in the mandible.