Dental Occlusion after Veau-Wardill-Kilner versus Minimal Incision Technique Repair of Isolated Clefts of the Hard and Soft Palate

Abstract

Objective To compare the Veau-Wardill-Kilner technique with a technique similar to the minimal incision technique described by Mendosa et al. on the basis of surgical complications and dentoalveolar status in the deciduous dentition. Design Retrospective study of medical and dental records and casts. Patients A consecutive series of 129 Caucasian children born with isolated cleft palate between 1980 and 1992. Main Outcome Measures From medical records, the variables of time for surgery, blood loss, complications in the immediate postoperative period, and frequency of fistulas were evaluated. On dental casts, the variables of sagittal, transversal, and vertical relations; structure of the palatal mucosa; and height of the palatal vault were studied. Results Time for surgery was shorter in the extensive clefts repaired with a Veau-Wardill-Kilner technique. Blood loss was higher using the Veau-Wardill-Kilner technique. The width of the upper jaw was significantly narrower in the Veau-Wardill-Kilner group, compared with the minimal incision group. Scar tissue and pits of the palate were more frequently found in the Veau-Wardill-Kilner group. Conclusions The minimal incision technique in this study has been shown to result in better development of the upper jaw with a better dental occlusion and palatal mucosa with significantly less scar tissue.

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

“…Jakobsson [9] has reported wider maxillary dental arches in 8-year-old children with ICP after abandonment of pushback palatal repair. According to Karsten et al [16] the width of the upper arch in children with ICP at 5 years of age was narrower in the Veau-Wardill-Kilner group when compared to the minimal incision technique described by Mendoza.…”

“…Palatal repair may affect palatal growth to some extent as the scar tissue in the palate may decrease dentoalveolar dimensions and alter occlusion [9,10,15,16]. Following VPP, a reduction in maxillary arch width at cuspids and molars and in arch length development has been documented [17].…”

Length of the cleft in relation to the incidence of hypodontia of the second premolar and to inheritance of cleft lip and palate in children with isolated cleft palate

“…The material has been presented in a previous study by Karsten and Larson [12]. The length of the cleft followed the definition presented by Karsten et al [13]. All files were thoroughly reread by two of the authors (AK and OL) before the start of this investigation to decide if the cleft of the hard palate was involved by more than 3 mm.…”

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

“…Both the method and timing of the palatal closure have since been changed in Finland. Wider maxillary dental arches have been reported in 8-yearold children with CP after abandonment of pushback repair [7] and in 5-year-old children with CP operated on by the newer minimal incision techniques described by Mendoza, when compared to those operated on using the Veau-Wardill-Killner technique [15]. Furthermore, impairment of the nasal airway [27], early feeding difficulties, and recurrent infections are typical of children with isolated CP.…”

“…However, palatal surgery may affect palatal growth and alter occlusion, as the scar tissue may decrease dentoalveolar dimensions [7,8,14,15]. 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].…”