Patterns of maxillary alveolar arch growth changes of infants with unilateral cleft lip and palate: preliminary findings.
OBJECTIVE
Because of significant differences in pathomorphology at birth, it may be that a better treatment outcome prognosis exists for patients with incomplete versus complete cleft forms. Can reaction patterns be extracted from changes in maxillary dimensions of different cleft forms within the first year of life to support this hypothesis?


METHODS
Chronologically consecutive casts of the maxilla (1 week and 3, 6, and 12 months of life) of 15 patients with complete unilateral cleft lip and palate (cUCLP) and 13 patients with incomplete unilateral cleft lip and palate (iUCLP). All patients were treated with passive palatal plates. Cheiloplasty was performed at 6 months of age. No primary osteoplastic surgery was carried out.


METHODS
Following digitizing with a three-dimensional laser scanner, all cast surfaces were computer reconstructed, aligned, and superimposed. Distances between the surfaces were determined and expressed graphically. Computer-aided determination of defined maxillary dimensions was performed. The volumes of segmented surfaces were determined and compared.


RESULTS
Within the first year of life, decreased sagittal but increased transverse alveolar growth for patients with iUCLP was found. The increase in alveolar crest length in patients with iUCLP was 50% less within the first year of life than in patients with cUCLP. In the same patients, the volumes of the molar segments were, on average, larger at each registration stage and the increase in these volumes larger within the first year of life.


CONCLUSIONS
Conclusions regarding the direction and extent of growth cannot be drawn from the visible level of severity of the malformation.
Braumann
Bert
B
Department of Orthodontics, Clinic for Oral and Maxillofacial Surgery, Center for Dentistry, University of Bonn, Bonn, Germany. braumann@uni-bonn.de
Keilig
Ludger
L
Stellzig-Eisenhauer
Angelika
A
Bourauel
Christoph
C
Bergé
Stefaan
S
Jäger
Andreas
A
D000539:Alveolar Process / Q000254:growth & development*; D002971:Cleft Lip / Q000473:pathology / Q000601:surgery; D002972:Cleft Palate / Q000473:pathology* / Q000503:physiopathology*; D003198:Computer Simulation; D003724:Dental Arch / Q000254:growth & development*; D003936:Diagnosis, Computer-Assisted; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008437:Maxilla; D008445:Maxillofacial Development; D003765:Models, Dental; D011379:Prognosis