Longitudinal Study of Effect of Hotz's Plate and Lip Adhesion on Maxillary Growth in Bilateral Cleft Lip and Palate Patients

Abstract

Lip adhesion showed a temporary negative effect. In all patients with BCLP, the surgeries affected the growth of the anterior arch width until the age of 5 years. Collapse of the premaxilla following labioplasty in the H (-) group affected the growth of dental arch length until the age of 5 years. Treatment using Hotz's plate prevented collapse of the premaxilla, and the growth of the arch length was comparable to that observed in the noncleft group.

Effects of labial adhesion on maxillary arch dimensions and nasolabial esthetics in cleft lip and palate: a systematic review

“…We also found that up to onefifth had wound dehiscence and up to 7% needed reoperation, which is not negligible for a procedure already requiring two operations. Although not described in our study, the use of labial adhesion as single preliminary step for definitive lip closure can cause a collapse of the maxillary segments toward the midline in unilateral CLP and bilateral CLP (Millard et al, 1999;Hak et al, 2012) and can, in this way, negatively affect the development of the maxillary arch dimensions and nasolabial esthetics. Labial adhesion in combination with infant orthopedics can facilitate definitive lip closure without collapse of the maxillary segments, with reduced tension on the labial segments, and by creation of a more symmetrical platform upon which allows the lip to be united and the nose to be corrected at an early stage (Cho, 2006).…”

“…Three hundred and eighty-nine patients had complete unilateral CLP and 198 had complete bilateral CLP. Eight studies (Meijer, 1978;Vander Woude and Mulliken, 1997;Millard et al, 1999;Prasad et al, 2000;Cho, 2006;Gatti et al, 2010;Ridgway et al, 2011;Hak et al, 2012) worked with prospectively collected data and more than half of the studies were published after 2005 (Cho, 2006;Nagy and Mommaerts, 2009;Gatti et al, 2010;Ridgway et al, 2011;Hak et al, 2012;Dissaux et al, 2015). Twelve studies (Meijer, 1978;Rintala and Haataja, 1979;Van der Beek et al, 1992;Vander Woude and Mulliken, 1997;Millard et al, 1999;Prasad et al, 2000;Bitter, 2001;Cho, 2006;Nagy and Mommaerts, 2009;Gatti et al, 2010;Ridgway et al, 2011;Dissaux et al, 2015) included 20 patients or more who underwent labial adhesion, with a maximum of 124 patients (Millard et al, 1999).…”

Current status of presurgical infant orthopaedic treatment for cleft lip and palate patients: A critical review

“…3 long term studies evaluating the efficacy of PSIO in BCLP patients have been included in the review out of which Ross and MacNamera [13] reported that conservative PSIO for BCLP patients does not have lasting effects on the esthetics of the lip and nose while Lee et al [20] stressed that nasoalveoalr molding combined with retrograde nasal reconstruction improves the quality of reconstructive outcome and decreases the number of surgical procedures. Hak et al [63] in a prospective longitudinal evaluation on 53 BCLP patients also showed that treatment with Hotz's plate until about 18 months of age prevented collapse of the pre-maxilla and supported the growth of dental arch length until the age of 5-year compared to non-cleft patients.…”

Presurgical Infant Orthopedics for Cleft Lip and Palate: A Review

“…They found that arch width and length of the anterior part of the maxillary were larger in the Hotz (+) group than in the Hotz and lip adhesion group, and in the group without Hotz plate and palatoplasty, at 5 years of age. The anterior part of the maxillary arch was wider in the Hotz group than in the other two groups [35]. In another long term study, Silvera et al concluded that The two-stage palatoplasty in combination with application of the Hotz' plate had good effects on the maxillary growth than one stage palatoplasty without Hotz plate up to the age of 12 years [36].…”