Dental arches in six-year-old children with operated and unoperated submucous cleft palate and isolated cleft palate

Abstract

The sizes of dental arches in 129 children with cleft palate were evaluated retrospectively from dental casts taken at the mean age 6.2 years (range 5.2-7.5). The material included 61 children with submucous cleft palate (SMCP) and 68 children with isolated cleft palate (ICP). Twenty of the children with SMCP were not operated on, while 41 had had surgical treatment, either palatal repair (n = 16, mean age at operation: 1.6 years, range 0.8-3.9) or pharyngeal flap (VPP) surgery (n = 25, mean age at operation: 4.5 years, range 2.6-6.2). In children with ICP, one-stage hard-palate and soft-palate closure had been done at the mean age of 1.5 years (range 1.0-2.1). Decreased maxillary intermolar widths were seen in children with SMCP after VPP, and especially after palatal repair. The children with ICP had the smallest maxillary dental arch widths. No significant differences were observed in the maxillary arch length or mandibular intermolar arch dimensions in children with SMCP or ICP. Surgery is associated with decreased maxillary intermolar arch widths in children with SMCP. Children with ICP had smaller maxillary dental arch widths than children SMCP.

Dental arches in submucous cleft palate: Comparison of six-year-old boys with unoperated submucous cleft palate, with operated cleft of the soft palate, and without a cleft

“…No difference has been reported in the maxillary arch length between the operated and unoperated children with SMCP [16]. The length of the maxillary dental arch in SMCP may be shorter because of the growth deficiency associated with clefting.…”

“…It seems that without surgical treatment there is no severe growth disturbance or reduction in maxillary arch widths in children with SMCP. According to a previous study [16], 6-year-old children with SMCP have decreased maxillary inter-molar widths after velopharyngeal surgery, and especially after palatal pushback repair, when compared with the SMCP children without surgery.…”

“…Surgical treatment of SMCP has been shown to be associated with decreased maxillary inter-molar arch widths in 6-year-old children compared to children with SMCP without surgery [16]. In children with CP, the sizes of dental arches in the primary, transitional, and permanent dentition have been reported to be smaller than in children without clefts [17Á20].…”

Influence of palatoplasty on occlusion of patients with isolated cleft palate

“…The literature shows that the transverse dimensions of the upper arch are small in cases of isolated cleft palate, regardless of the extension of the cleft or surgical technique employed. Studies that quantitatively assess the transverse dimension of the dental arches report a reduction of this dimension on the upper arch during the three developmental stages of the occlusion: Primary, 3,7,11,12,14,20,21,22 mixed 3,7,13,14 and permanent. 3,29 The literature also suggests that the lower arch tends to follow the upper arch, diminishing its transverse dimensions during the primary dentition, 3,12,20,22 on the other developmental stages of the occlusion 3 and on the permanent dentition.…”

“…With regards to the occlusion, the literature has shown that palatoplasty in isolated cleft palate affects the development of the upper dental arch, with a reduction in width 11,15,20,29 (Fig 2A) or in width and length 3,7,10,12,14,21,22 with variations depending on the surgical technique 15,20 and on number of surgeries performed. 10 Moreover, the lower arch tends to follow the constriction of the upper arch ( Fig 2B).…”