The evaluation of the effects of rapid palatal expansion on nasomaxillary complex in patients with complete unilateral and bilateral cleft lip and palate

Abstract

Aim: The aim is to evaluate the effects of rapid palatal expansion (RPE) in children with complete unilateral and bilateral cleft lip and palate (UCCLP/BCCLP), compared with noncleft patients. Materials and Methods: This study includes 45 patients aged between 8 and 11 years old (15 patients with UCCLP; mean age: 9 years 2 months, 15 patients with BC-CLP; mean age: 9 years, 15 patients with noncleft; mean age: 9 years 1 month), in Ege University, Department of Orthodontics. RPE was applied before secondary alveolar grafting. Posteroanterior cephalograms were taken before and after expansion. One-way analysis of variance was used to analyze the differences among the groups, whereas the paired t-test was used to evaluate the changes in each group. Results: In all groups, RPE causes a significant increase of the internasal dimension and maxillary width (Ln-Ln', Mx-Mx'). In the cleft groups, especially in the bilateral CLP group, the nasal width (Ln-Ln') and maxillary width (Mx-Mx') show a statistically significant increase according to the control group (P < 0.001). Furthermore, the unilateral CLP group shows an increase according to the control group (P < 0.001).(Um-Um') and (Lm-Lm') show a statistically significant increase all in three groups compared before the treatment (P < 0.001).(Um-Um') show the most increase in bilateral CLP group (P < 0.001). In the bilateral CLP group, (Zyg-Zyg'), (Cdl-Cdl'), (Go-Go') show a statistically significant increase (P < 0.001). The control and unilateral CLP group also show an increase, but the unilateral CLP group is not found statistically significant. Conclusion: When the facial morphologies were evaluated after RPE, the facial width measurements of the bilateral CLP patients showed a greater increase than the unilateral CLP and control group. Nasal width measurements were wider in cleft groups compared to the control group contributing to a widened airway, which may have an effect on breathing and speaking in cleft patients. More studies are needed.