Is the early mixed dentition dental arch relationship related to the anteroposterior alignment of the maxillary segments in infants with CUCLP?

Abstract

Objective: Midface retrusion is a concern in patients with complete unilateral cleft lip and palate (CUCLP). Maxillary segment alignment may influence the prognosis after corrective surgery. This study assessed the association between maxillary segment alignment and interarch relationship observed in the early mixed dentition. The null hypothesis was that there is no relation between the initial alignment of cleft segments and the width of the cleft in the infant, and the early mixed dentition interarch relationship. Setting and Sample Population: The sample consists of 352 children with CUCLP treated at the Hospital for Rehabilitation of Craniofacial Anomalies/USP. Material And Methods: Dental models were obtained before lip repair at three months and at the age of six. Based on the first, the sample was then divided into two groups: anteroposterior aligned and anteroposterior misaligned maxillary segments. They were also divided into 4 groups according to the cleft width (Narrow, Medium, Wide and Very Wide). Interarch relationship was graded using the 5-year-old index. The statistical association was evaluated using the chi-squared test (P < .05). Results: Cleft width was inversely related to interarch relationship in the early mixed dentition phase. Interarch relationship at the age of six was more favourable in children with misaligned maxillary segments than in children with aligned segments (P = .048). Conclusion: Five-year interarch relationship in patients with CUCLP is related to the anteroposterior relationship of infant maxillary segments and initial cleft width before primary surgeries. Wide alveolar clefts and sagittally aligned maxillary segments showed a worse interarch relationship in the early mixed dentition.

Correlation between cleft width and dental arch symmetry in cleft lip and palate: a longitudinal study

“…Considering that palate width is a negative predictor of palate development, 5,11,15,23,27 we emphasize the importance of further evaluation of cleft palate width. The proposal of a cleft width classification would contribute to determining the influence of cleft width on palate growth and treatment protocols.…”

“…Numerous parameters can influence the symmetry of dental arches. 5,11,14,15 However, this study focused on the understanding of cleft width, considering the lack of width classifications.…”

“…[5][6][7][8] Residual or persistent asymmetry usually occurs after primary plastic surgeries and requires further therapeutic approaches (secondary plastic surgery or orthopedic treatment) for correction of anatomic and/ or functional problems. 5,[9][10][11] Symmetry in individuals with cleft lip and palate has been evaluated in both soft and hard tissues. 12 The analysis of palate symmetry in children is essential before and after surgical repairs.…”

“…5,13 Palate asymmetry in children with craniofacial anomalies is correlated with factors such as orofacial cleft phenotype classification, treatment protocol, cleft length, and cleft width. 6,11,14,15 However, the literature lacks studies on the influence of cleft width before and after surgical repairs. Moreover, no study so far has explained which cleft width (anterior, middle, or posterior) would play a role in dental arch symmetry in children.…”