Speech evaluation and dental arch shape following pushback palatoplasty in cleft palate patients: Supraperiosteal flap technique versus mucoperiosteal flap technique.
BACKGROUND
The aim of this study was to evaluate and compare the maxillary dental arch shape and speech of cleft palate patients following pushback palatoplasty using either the supraperiosteal flap technique or the mucoperiosteal flap technique.


METHODS
Sixty-two patients (29, cleft palate only; 33, unilateral cleft lip, alveolus and palate) operated on by the supraperiosteal technique and 47 patients (23, cleft palate only; 24 unilateral cleft lip, alveolus and palate) by the mucoperiosteal technique were reviewed in this study.


METHODS
Dental arch shape and speech proficiency at preschool and school age were evaluated in all patients.


RESULTS
Dental arch shapes were classified as U type (good dental arch shape) and V type (narrow dental arch shape). In cleft palate only patients, U type was observed in 90% of the supraperiosteal group and 83% of the mucoperiosteal group. In unilateral cleft lip, alveolus and palate patients, U type was observed in 85% of the supraperiosteal group, while only in 33% of the mucoperiosteal group. In cleft palate only patients, normal speech at school age was observed 100% of the supraperiosteal group and 83% of the mucoperiosteal group. In unilateral cleft lip, alveolus and palate patients, normal speech at school age was observed in 97% of the supraperiosteal group and 75% of the mucoperiosteal group. Misarticulation was frequently found in patients with the V type of dental arch shape.


CONCLUSIONS
It is suggested that pushback palatoplasty using the supraperiosteal technique is more advantageous for speech development compared with the mucoperiosteal technique.
Department of Oral Surgery, Sapporo Medical University and School of Medicine, Sapporo, Japan.
Shizuyo
S
Ito
Makoto
M
Noguchi
Yoshiyuki
Y
Suda
Akira
A
Yamaguchi
Geniku
G
Kohama
Etsuhide
E
Yamamoto
D001184:Articulation Disorders / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D002971:Cleft Lip / Q000503:physiopathology / Q000601:surgery*; D002972:Cleft Palate / Q000503:physiopathology / Q000601:surgery*; D003724:Dental Arch / Q000033:anatomy & histology*; D006801:Humans; D007223:Infant; D013060:Speech; D013524:Surgical Flaps; D014681:Velopharyngeal Insufficiency / Q000503:physiopathology / Q000601:surgery