The basis for presurgical orthopedic treatment of infants with unilateral complete cleft lip and palate

Objective: The purpose of this study was to describe the posttreatment morp hology of the upper part of the oral cavity of complete unilateral cleft li p and palate (UCLP) patients and to compare it to noncleft contemporaries. Patients were treated according to a protocol designed to keep a proper res ting posture of the oral cavity, Design: Retrospective study on dental casts. Setting: The study was performed at a maxillofacial center serving a popula tion of 2 million inhabitants. Data for noncleft subjects are the result of a longitudinal study at the same institution. Patients: Twenty-one Caucasian UCLP patients (13 males, 8 females) aged 5 t o 9 years with no other congenital anomalies and no postoperative orthodont ic treatment. interventions: Each patient received 5 to 6 months of preoperative orthoped ics with a passive plate and external nonelastic strapping with definitive lip repair at age 5 to 7 months, soft palate repair at 11 to 15 months, and hard palate repair with mucoperiosteal closure of the alveolus at 30 to 36 months. Each patient was compared to the mean values obtained from a longi tudinal study of a group of 25 healthy noncleft children of the same ethnic group (11 males, 14 females). Results: Analysis of dental casts indicated that 16 patients had a width, d epth, and length of the alveolar arch in the range of the mean normal value s minus two standard deviations. Their analyzed palates were flatter than n ormal. Six of 21 children had too small an alveolar arch for their ages, an d they did not acquire a correct posture of the oral cavity, Conclusion: The results indicate that the upper part of the oral cavity of UCLP patients can reach the dimensions of noncleft contemporaries despite s urgery.