Changes produced by presurgical orthopedic treatment before cheiloplasty in cleft lip and palate patients.
OBJECTIVE
The purpose of this study was to test the hypothesis that, with the use of preoperative treatment, the dimensions of the upper part of the oral cavity of an infant with unilateral cleft lip and palate (UCLP) become more similar to those of a noncleft infant.


METHODS
This was a retrospective study of upper dental casts taken at birth and prior to lip repair at 6 months of age. A treated group, an untreated group, and a group of noncleft contemporaries were compared cross-sectionally and longitudinally. Models were analyzed by the trigonometric method.


METHODS
The study was performed at a maxillofacial center servicing a population of two million.


METHODS
The treated group consisted of 24 babies born after 1990 with UCLP that started presurgical treatment within 20 days of life. The untreated group consisted of 25 randomly selected UCLP casts taken at birth and 25 casts taken just before lip surgery. The noncleft group consisted of 25 full-term infants whose mothers participated in the longitudinal growth study. All participants belonged to the same ethnic group.


METHODS
Presurgical treatment consisted of the babies constantly wearing a thin, passive acrylic plate mimicking the normal palate and a slim adhesive tape fixed to the lip segments to bring them slightly together.


RESULTS
The upper oral cavity in a newborn with UCLP was significantly larger than in a noncleft infant, the only exception being in the sagittal dimension. After presurgical treatment, the upper oral cavity was remodeled and slightly enlarged; there was a lesser difference from the noncleft at 6 months than at birth. The cleft in the alveolus reduced significantly, and the position of the incisive point improved. The group without presurgical treatment had no remodeling, and the growth dynamics were similar to the noncleft so that the dimensional differences from the normal remained the same as at birth.


CONCLUSIONS
The morphological characteristics of the upper part of the mouth change if the functional conditions in the oral cavity are changed. Infants with presurgical orthopedics become more similar to noncleft contemporaries than those without presurgical orthopedics.
Kozelj
V
V
Department of Maxillofacial and Oral Surgery, University Hospital Ljubljana, University in Ljubljana, Slovenia. vesna.kozelj@mf.uni-lj.si
D002971:Cleft Lip / Q000628:therapy*; D002972:Cleft Palate / Q000628:therapy*; D003430:Cross-Sectional Studies; D005069:Evaluation Studies as Topic; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008137:Longitudinal Studies; D009055:Mouth / Q000254:growth & development / Q000502:physiology; D009984:Orthopedic Fixation Devices; D010158:Palatal Obturators; D012189:Retrospective Studies