The influence of different types of hard palate closure in two-stage palatoplasty upon palatal growth: dental cast analysis.

Abstract

We investigated the influence of different types of hard palate closure in two-stage palatoplasty. In 12 cases the lip and soft palate were closed at the age of 3 to 7 months; these 12 were then divided into two groups. The hard palate was closed at the age of 1 year 5-11 months by the vomer flap with skin graft in the vomer flap (VF) Group (Osada's two-stage palatoplasty), and by push-back procedure of the mucoperiosteal flap in the push-back (PB) Group. Dental casts of the two groups were measured and compared at the ages of 0, 1, 3-4, and after 10 years. 1) In spite of apparent differences in palatal configurations at the age of 3-4 years, no significant differences in palatal size and area were noted between the groups. The cross-sectional areas in the VF Group were significantly larger than those in the PB Group in all the sections. 2) When the two groups were compared for rates of growth from 1 to 3-4 years, no significant differences in palatal size were noted, except in palatal width 1, although palatal growth from 1 to 3-4 years was more consistent and favorable in the VF Group. The rates of growth or change in palatal area and cross sectional-area 2 were significantly larger in the VF Group. 3) In spite of the apparent difference in palatal configuration, after age 10, no significant differences in palatal size, area, and depth were noted except in cross-sectional area 2.