Effects of early and late cheiloplasty on anterior part of maxillary dental arch development in infants with unilateral complete cleft lip and palate

Abstract

Objectives. The objective of this study is to compare the impact of early and late reconstruction of complete unilateral cleft lip and palate on the growth and development of the front of the dentoalveolar arch. Methods. This study was carried out in the years 2012–2015 at the Clinic of Plastic, Reconstructive and Aesthetic Surgery in Banska Bystrica. Infants with unilateral complete cleft lip and palate were divided into 2 groups according to the timing of lip reconstruction. Group A consisted of infants with early lip reconstruction–realised in the first 14 days of life. Group B consisted of infants with later lip reconstruction–realised in the third month of age. Maxillary dental casts were obtained for each child in four periods–in the first 14 days of life, in the third month, in the sixth month and in the age of one year. These were followed by the identification, measurement and evaluation of anthropometric parameters. Results. Significant differences were occurred after the reconstruction of the lips in linear and angle measurements between infants in the A and B groups. Conclusion. The early surgical reconstruction of the lips in the first 14 days of life has a positive effect on the growth and development of the anterior segment of the dentoalveolar arch. Early lip reconstruction forms a continuous pressure on the frontal segment, resulting in the earlier remedy of anatomical properties and creates appropriate conditions for the best development of this area.

Duration of Surgery, Ventilation, and Length of Hospital Stay Do Not Affect Breastfeeding in Newborns After Early Cleft Lip Repair

“…The second reason could be the different weaning policy according to institutional guidelines in both neonatal departments. Longer duration of surgery in hospital B could be due to the fact that there was a special otolaryngology team in hospital B and before every surgery 3 dimensional measurements of the palate were done (Valentova-Strenacikova and Malina, 2016). Although the differences in length of surgery and artificial ventilation during and after surgery were statistically significant, these may not probably have a significant influence on clinical outcome.…”

What Are the Effects on Palate of Early Lip Surgery in Children With Cleft Lip and Palate? Cross-Sectional Evaluation From 5-Year-Old

“…Few studies verified angular measurements in palatal development of children with cleft lip and palate. The 1-year postcheiloplasty angular measurements have demonstrated a significant reduction of the values, even using different anatomic points 10–12 …”

Favorable Transverse Maxillary Development after Covering the Lateral Raw Surfaces with Buccal Fat Flaps in Modified Furlow Palatoplasty: A Three-Dimensional Imaging–Assisted Long-Term Comparative Outcome Study

“…[47][48][49][50] It has been demonstrated that cleft lip repair mainly affects the anterior width of the maxilla by exerting continuous pressure, with little effect on the posterior width. 42,43,[48][49][50] The raising of mucoperiosteal flaps plus secondary healing process with scarred tissue formation in the lateral denuded areas could result in narrowing of the posterior maxillary width. 14,17,40,42,44 Therefore, patients with repaired unilateral cleft lip and palate generally present with a more severe transverse constriction of the posterior maxillary region compared with children with repaired unilateral cleft lip, 14,17,39,40,42,44 demonstrating that the palatoplasty could lead to restriction of the transverse development in the posterior region.…”

“…32,46 Because of the absence of maxillary arch continuity and lateral displacement of the maxillary segments in unilateral cleft lip and palate deformity, children with this particular form of cleft present wider transverse maxillary dimensions before primary operations compared with children with an isolated cleft lip deformity. [47][48][49][50] It has been demonstrated that cleft lip repair mainly affects the anterior width of the maxilla by exerting continuous pressure, with little effect on the posterior width. 42,43,[48][49][50] The raising of mucoperiosteal flaps plus secondary healing process with scarred tissue formation in the lateral denuded areas could result in narrowing of the posterior maxillary width.…”