The deciduous dentition after only primary surgical operations for clefts of the lip, jaw, and palate

Abstract

The purpose of the present study was to investigate the occlusal status of the deciduous dentition in children with clefts of the lip, jaw, and palate for which only soft-tissue surgery has been performed without presurgical orthodontic treatment of the jaw or primary bone grafting. The material comprised forty children who underwent primary operations for congenital oral defects of various types at the Department of Plastic Surgery in Örebro during the period from 1964 to 1967. The patients were divided into five groups according to the nature of the clefts. Their mean age at the time of the examination was 4.9 years. No major anomalies in the deciduous dentition were found in the group with a soft-tissue cleft only (cheiloschisis). The highest incidence of malocclusion was found, as expected, among the children whose clefts involved bone. The incidence of cross-bite was relatively high (44 per cent) among the patients on whom primary surgical procedures were performed for correction of clefts in the hard and/or soft palate. Among the children with total clefts on only one side, a postnormal relation on that side was found in approximately 80 per cent, as compared with 25 per cent on the opposite side. Among these children the incidence of cross-bite on the side of the cleft was 75 per cent, and on the opposite side it was 25 per cent. Frontal inversion was observed in about 30 per cent of these children. These frequencies of cross-bite and frontal inversion among children with unilateral total clefts were in agreement with the findings of two previous studies of a similar nature. The incidences of cross-bite and frontal inversion were lower in the present study than in material where presurgical orthodontic treatment of the jaw and early bone grafting were undertaken in conjunction with the treatment of the oral cleft. The differences, however, are not statistically significant.