title: [What effect does using the Latham devices have on craniofacial growth in uni- and bilateral lip-jaw-palate clefts].
abstract: Primary gingivoperiosteoplasty according to Millard consists of active presurgical orthopedic treatment with the Latham device at the age of 4 months and surgical covering of the alveolar cleft by local mucoperiosteum flaps at the age of 6 months. The aim of this investigation was to evaluate the facial growth following use of the Latham device. Lateral head X-rays and plaster casts from 146 patients with unilateral and bilateral clefts of lip and palate were investigated (follow-up of 16 years). Ninety-one of these patients formed the control group and received no Latham device and no gingivoperiosteoplasty. The same surgeon and orthodontist treated all of the 146 patients. Three-dimensional growth disturbance was observed after application of the Latham device and gingivoperiosteoplasty. Forty-two percent of patients with UCLP and 40% patients with BCLP had an "open bite" following closure of the alveolar cleft (control group 5%-10%): the length of the upper jaw was shorter than in the control group and the frequency of cross-bite was higher. These results demonstrate that treatment with a Latham device followed by gingivoperiosteoplasty disturbs facial growth. Therefore this treatment should be rejected.
authors.affiliation: Klinik für Mund-Kiefer-Gesichtschirurgie und Plastische Operationen, Universität Rostock.
authors.forename: K O
authors.initials: KO
authors.lastname: Henkel
authors.forename: K K
authors.initials: KK
authors.lastname: Gundlach
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002971:Cleft Lip / Q000503:physiopathology / Q000628:therapy*; D002972:Cleft Palate / Q000503:physiopathology / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D005893:Gingivoplasty; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D008445:Maxillofacial Development / Q000502:physiology*; D009967:Orthodontic Appliances; D010348:Patient Care Team; D012189:Retrospective Studies; D013524:Surgical Flaps; D016896:Treatment Outcome