Maxillary protraction by reverse headgear treatment in patients with unilateral cleft lip and palate: A cephalometric evaluation

Abstract

Objective: This investigation was undertaken with the primary aim of evaluating the effects of reverse headgear therapy in patients with unilateral cleft lip and palate (UCLP) using lateral cephalograms and to compare the results of the reverse headgear treatment in these patients with other patients with UCLP who did not receive any orthopedic/orthodontic treatment. Materials and Methods: The treated group comprised 17 patients (13 male, 4 female; mean age 9.28 ± 2.78 years) with repaired complete UCLP and untreated group consisted of 5 subjects (4 male, 1 female; mean age 8.25 ± 2.25 years) with repaired complete UCLP. All patients in treated group received maxillary protraction with a Delaire type reverse headgear along with a customized intraoral splint worn for 16–18 h daily with force in the range of 420–480 g. Subjects in the untreated group did not receive any orthopedic/orthodontic treatment. Average treatment/observation period was 11.62 months for the treated and 12.40 months for the untreated group. Changes were evaluated at the end of the treatment and observation period by comparing pre- and post-lateral cephalograms. Results: Treatment effects of reverse headgear therapy were significant for anterior positioning of maxilla, clockwise rotation of mandible, proclination of upper incisors, and forward movement of upper molars as shown by cephalometric analysis. The untreated group did not show any significant changes, for the same measurements. Conclusions: Reverse headgear treatment is an effective method of improving the maxillomandibular relationship in patients with UCLP.