Comprehensive care of cleft lip and palate children at Zürich University: A preliminary report

Bilateral cleft lip and palate. Maxillofacial growth and dental development

“…Concerning the diminished growth of the intertuberosity distance, it can be probably ascribed to the wearing of the plate, which holds the palate off from the outward pull of the clefted palatal muscles. Moreover, in contrast to the frontal side of the plate, which is grinded away at least every three weeks, the tuber side was left unchanged during this period (Hotz and Gnoinski, 1976). Additionally, a positive growth velocity in transverse width of the premaxilla was observed during the same period, while growth velocity of the premaxilla depth was less and even negative after lip closure.…”

“…All babies underwent presurgical orthopaedic treatment according to Hotz and Gnoinski (1976) with an intraoral acrylic plate of soft and hard acrylic combined with extra-oral strapping. Lip closure was performed in one stage using a modified Manchester technique (Manchester, 1970).…”

“…Specially designed feeding-bottle teats are available for use in these conditions. Also, some authors pretend that the plates used in early orthopaedics facilitate feeding (Hotz and Gnoinski, 1976;Brine et al, 1994). At a later age, in children with a BCLP mastication can be disturbed due to an incorrect position of the teeth and/or bad jaw relation.…”

“…The main benefits advocated by those who perform presurgical orthopaedic treatment (PSOT) are as below (Hotz and Gnoinski, 1976;Foster, 1980;Hathorn, 1986).…”

“…By fitting an acrylic plate over the hard palate cleft a more normal oral environment is created, while the tongue is kept out of the cleft. These changes would result in better feeding (Hotz and Gnoinski, 1976;Brine et al, 1994).…”