Cephalometric and occlusal outcome in adults with unilateral cleft lip, palate, and alveolus after two different surgical techniques.
OBJECTIVE
To assess differences in the aesthetic and functional long-term results of one-stage and two-stage surgical and orthodontic treatment in patients with cleft lip, palate, and alveolus.


METHODS
Sixty adult patients who were operated on as children for unilateral cleft lip, palate, and alveolus were examined. In every patient the lip was closed using Tennison's technique. Thirty patients had soft and hard palate closure in two stages and 30 patients in a single stage. Lateral cephalometric and model analyses were conducted at a mean age of 18.4 years.


RESULTS
In the model analysis, transverse narrowing was seen in all patients after two-stage operations and in three patients after one-stage operations. The deficit was more severe in the molar region in the two-stage group and nearly similar in the premolar and molar region in the one-stage group. A sagittal deficiency in the anterior maxilla was found in 26 patients after two-stage operations and in 16 patients after one-stage operations. In the lateral cephalometric analysis, the mean sella-nasion-point A angle in the one- and two-stage group was 78.2 degrees and 76.8 degrees, respectively. The ANB angle was normal in both groups. In both groups the inclination of the midface was low. There was a low posterior facial height. Minor scarring was seen in the single-stage group.


CONCLUSIONS
A more severe impairment of growth of the maxilla in the sagittal and frontal plane was observed after two-stage operations on the cleft palate.
Department of Oral and Maxillofacial Surgery, University Hospital, Graz, Austria.
Alexander
A
Gaggl
Matthias
M
Feichtinger
Günter
G
Schultes
Gert
G
Santler
Margit
M
Pichlmaier
Rudolf
R
Mossböck
Hans
H
Kärcher
D000293:Adolescent; D000328:Adult; D000539:Alveolar Process / Q000002:abnormalities / Q000601:surgery; D002508:Cephalometry; D002921:Cicatrix / Q000209:etiology; D002971:Cleft Lip / Q000601:surgery; D002972:Cleft Palate / Q000601:surgery*; D003766:Dental Occlusion; D006801:Humans; D008445:Maxillofacial Development; D019647:Oral Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D009971:Orthodontics, Corrective; D021362:Palate, Hard / Q000601:surgery; D010160:Palate, Soft / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome